A Randomised Clinical Study on Haemodynamic Effects of Thiopentone and Etomidate as Induction Agents in General Anaesthesia UC05-UC08
Department Of Anaesthesiology, R G Kar Medical College, 1 Khudiram Bose Sarani, Kolkata, West Bengal, India.
Introduction: Thiopentone and Etomidate like anaesthetic agents are often used for induction during anaesthesia. Induction is the preliminary step in general anaesthesia and the search for a perfect agent is a persistent quest for the anaesthetist.
Aim: To compare the haemodynamics status and safety profile of thiopentone and etomidate as induction agent.
Materials and Methods: The present randomised clinical trial was conducted on 120 patients, of either sex between 18-45 years of age belonging to American Society of Anesthesiology (ASA) grade I and II. They were divided into two groups with 60 patients in each. Group T patients were induced with injection (inj.) thiopentone 5 mg/kg and Group E patients were induced with inj. etomidate 0.3 mg/kg as an induction agent. Vital parameters like heart rate, non invasive blood pressure of all patients was recorded at baseline (before induction), after induction and post intubation at an interval of 1, 3 and 5 minutes. Adverse effects during intraoperative period were noted and later analysed. Quantitative data were analysed using unpaired t-test to assess the changes within group.
Results: A total of 120 (70 males and 50 females) study participants (18-45 years of age) were divided into two groups( group T induced with thiopentone and group E induced with etomidate) of 60 subjects each. The induction time in the Group E (27.5±3.31 seconds) was significantly less (p<0.05) as compared to Group T (31.71±4.8 seconds). Change in heart rate was lesser (p<0.05). There were no significant changes in the respiratory rate in either at any stage of anaesthesia. Adverse effects like apnoea were evident more in the Group T patients whereas pain at injection site and myoclonus was more evident in the Group E patients. But, the overall safety profile of etomidate was better than thiopentone.
Conclusion: Etomidate found to be more effective, rapid acting induction anaesthetic agent with good cardiovascular stability and respiratory stability with least incidences of apnoea as compared to thiopentone.