Efficacy of propofol at different doses combined with etomidate for general anesthesia induction

HU Keshi; WANG Miaomiao; YANG Meihua; FENG Zeguo

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Medical Journal of the Chinese People Armed Police Forces ›› 2021, Vol. 32 ›› Issue (3) : 231-234.

ORIGINAL ARTICLES

Efficacy of propofol at different doses combined with etomidate for general anesthesia induction

HU Keshi, WANG Miaomiao, YANG Meihua, FENG Zeguo

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Abstract

Objective To explore the changes of hemodynamics and bispectral index (BIS) when propofol is combined with etomidate for induction of general anesthesia. Methods Ninety patients scheduled for general anesthesia in our hospital between October 2018 and March 2019 were enrolled. These patients were randomly divided into three groups,with 30 patients in each group. Anesthesia induction methods included propofol 1.5 mg/kg + etomidate 0.075 mg/kg in group A, propofol 1 mg/kg + etomidate 0.15 mg/kg in group B, and propofol 0.5 mg/kg + etomidate 0.225 mg/kg in group C.MAP, HR, BIS were measured before induction (T₀),before intubation (T₁), and 1,3 and 5 minutes after intubation (T_2～4).Such adverse reactions as injection pain and myoclonus in each group were recorded. Results MAP and HR in group A were lower than in the other two groups, but BIS in group A was higher(P<0.05).MAP in group C increased significantly at T₂(P<0.05), and BIS in group A was higher than in group C at T_1-2(P<0.05).The incidence of injection pain was lower in group A and group B(P<0.05).The incidence of myoclonus was lower in group A and group B than in group C(P<0.05). Conclusions Propofol 1.5 mg/kg combined with etomidate 0.075 mg/kg is a better agent for general anesthesia induction as evidenced by hemodynamic and BIS stability and fewer adverse reactions.

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propofol / etomidate / general anesthesia induction / hemodynamics / BIS

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HU Keshi, WANG Miaomiao, YANG Meihua, FENG Zeguo. Efficacy of propofol at different doses combined with etomidate for general anesthesia induction[J]. Medical Journal of the Chinese People Armed Police Forces. 2021, 32(3): 231-234

References

[1] Soleimani A,Heidari N,Habibi M R, et al. Comparing hemodynamic responses to diazepam, propofol and etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery: a double-blind, randomized clinical trial[J]. Med Arch,2017,71(3):198-203.
[2] Arbous M S, Grobbee D E, Kleef J W, et al. Mortality associated with anaesthesia :a qualitative analysis to identify risk factors [J]. Anaesthesia, 2001,56(12):1141-1153.
[3] Zhou X, Li BX, Chen L M, et al. Etomidate plus propofol versus propofol alone for sedation during gastroscopy: a randomized prospective clinical trial [J]. Surg Endosc,2016,30(11):5108-5116.
[4] Edwards N D, Alford A M, Dobson, et al. Myocardial ischaemia during tracheal intubation and extubation [J]. Br J Anaesth,1994,72: 537-539.
[5] Möller P A, Kamenik M. Bispectral index-guided induction of general anesthesia in patients undergoing major abdominal surgery using propofol or etomidate: a double-blind, randomized, clinical trial [J]. Br J Anaesth,2013,110:388-396.
[6] Huibao Z,Yuexin Z, Kaizheng C. The effect of etomidate or propofol on brainstem function during anesthesia induction: a bispectral index-guided study [J]. Drug Des Devel Ther,2019,13:1941-1946.
[7] Hannam J A, Mitchell S J, Cumin D,et al. Haemodynamic profiles of etomidate vs propofol for induction of anaesthesia: a randomised controlled trial in patients undergoing cardiac surgery [J]. Br J Anaesth,2019,122(2):198-205.
[8] Moosavi, Tekye, Pashang. Comparison of the hemodynamic effects of etomidate versus propofol, rapid sequence intubation, on none surgical patients [J]. Med J Mashad Univ Med Sci,2014,57(4):602-608.
[9] 王卫东,邓文伟.异丙酚及依托咪酯麻醉诱导对循环系统的影响[J].中国局解手术学杂志,2002,11(6):149.
[10] 刘鸿文,罗红,邹渊.依托咪酯复合丙泊酚麻醉在老年胃肠镜检查中的应用效果及安全性分析[J].当代医学,2020,26(18):141-142.
[11] 邓彩英,覃兆军,陈小波,等.丙泊酚联合依托咪酯对全麻诱导气管插管期间血流动力学的影响[J].广东医学,2012,33(3):401-403.
[12] Wit F, Vliet A L, Wilde R B, et al. The effect of propofol on haemodynamics: cardiac output, venous return, mean systemic filling pressure, and vascular resistances [J]. Br J Anaesth, 2016,116:784-789.
[13] Willingham M D, Avidan M S. Triple low, double low: it's time to deal Achilles heel a single deadly blow [J]. Br J Anaesth,2017,119(1):1-4.
[14] 李杰,顾冰,毛广婷,等. 脑电双频指数监测下不同麻醉深度对老年患者术后早期认知功能影响的Meta分析[J].中国老年学杂志,2020,40(5):992-997.
[15] Schneider G, Gelb A W, Schmeller B, et al. Detection of awareness in surgical patients with EEG-based indices: bispectral index and patient state index [J]. Br J Anaesth,2003,91:329-335.
[16] 廖朝辉,幸标,沈娴文,等.咪唑安定和芬太尼对依托咪酯所致肌阵挛的影响[J].临床麻醉学杂志,2010,26(2):129-131.
[17] Kelsaka E, Karakaya D, Sarihasan B, et al. Remifentanil pretreatment reduces myoclonus after etomidate [J]. J Clin Anesth,2008,18:83-86.
[18] Liu J, Liu R, Meng C, et al. Propofol decreases etomidate-related myoclonus in gastroscopy [J]. Medicine (Baltimore),2017,96(26):7212.
[19] Yates A M, Wolfson A B, Shum L, et al. A descriptive study of myoclonus associated with etomidate procedural sedation in the ED [J]. Am J Emerg Med, 2013,31:852-854.
[20] Schwarzkopf K R, Hueter L, Simon M, et al. Midazolam pretreatment reduces etomidate-induced myoclonic movements [J]. Anaesth Intensive Care, 2003, 31: 18-20.
[21] 佟华丽,简道林,邹学军,等. 依托咪酯与丙泊酚联合诱导对全身麻醉患者血流动力学的影响[J].重庆医学,2012,41(27):2864-2866.