Hemodynamics Clinical Trial
Official title:
Comparison of Induction Characteristics of Two Anaesthetic Agents-Etomidate Lipuro and Propofol
The ideal induction agent for day care surgery should have properties of rapid, smooth
induction, better haemodynamic profile, faster recovery and devoid of side effects in the
form of pain on injection, involuntary movements, respiratory depression and post-operative
nausea/vomiting. Propofol is the drug being used for day care surgeries because of its
rapid, smooth induction and faster recovery. But its use is associated with pain on
injection (even with added lidocaine), hypotension and respiratory depression. So the need
for an agent with better hemodynamic control and lesser side effects was felt. The
introduction of etomidate lipuro revolutionised the anaesthesia practice. It possesses many
of the properties of an ideal induction agent. This newer formulation of etomidate in lipid
emulsion i.e. etomidate lipuro is known to have rapid, smooth induction, haemodynamic
stability and lesser side effects than older etomidate with propylene glycol (hypnomidate).
Hence, investigators devised a prospective randomized controlled open trial and compared
this newer lipid formulation of etomidate with propofol in terms of - induction time,
haemodynamic parameters and side effect profile.
The administration of a suitable drug by intravenous route for induction of anaesthesia has
been an important component of anaesthetic management.The ability to deliver safe and
effective anaesthesia with minimal side effects and rapid recovery is critically important
to ensure safe and early discharge. An ideal intravenous (IV) anaesthetic agent should, have
rapid onset, rapid recovery, be without undesirable cardiac and respiratory depression and
lesser untoward effects like pain on injection, nausea, vomiting etc.No single drug is
ideal.
Propofol (propofol 1%) has a smooth and rapid induction, rapid recovery, cerebro-protective
effect but it causes hypotension, bradycardia, respiratory depression pain on
injection.Etomidate is a hypnotic agent causing minimal histamine release and very stable
hemodynamic profile. In the present study, investigators evaluated the induction
characteristics and side effect profile of this newer lipid formulation of etomidate and
compared it with propofol in same lipid formulation.
Material and Methods: Hundred ASA I & II patients in the age group 18-60 yrs, scheduled for
dilatation and curettage procedure were randomly allocated in two groups based on induction
agent Etomidate lipuro or Propofol.
Both groups received intravenous midazolam 0.02mg /kg and fentanyl 2 µg /kg as
premedication. After induction with the desired agent titrated to bispectral index Entropy
40, the time to achieve BIS values to 40 (BIS 40 time) were measured. Heart rate, mean
arterial pressures were recorded at baseline, induction and upto 10 minutes. Patients were
asked for pain at the injection site, postoperative nausea and observed visually for
myoclonus, apnea and thrombophlebitis.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Screening
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