Comparative Evaluation of Effect of Propofol, Etomidate and a Combination of Propofol and Etomidate on the Hemodynamic Response to Induction and Endotracheal Intubation: A Prospective Randomized Double Blinded Study

Objective: Earlier studies have shown favorable hemodynamics with etomidate compared to propofol. Our study aimed to compare the hemodynamic characteristics of intravenous induction with precalculated doses of propofol, etomidate, and a combination of propofol-etomidate in adult surgical patients. Methods: One hundred twenty six patients aged 18 to 50 years of either sex and ASA physical status I scheduled for various surgeries under general anesthesia were recruited. Patients were randomized into three groups. Group P-induced with pre-calculated propofol (2 mg kg-1) intravenous, Group E with etomidate (0.3 mg kg-1) intravenous, and Group PE with propofol (1 mg kg-1) plus Etomidate (0.2 mg kg-1) intravenous. Heart rate, systolic, diastolic, and mean arterial blood pressure at baseline, 2, and 3 minutes after induction and then at 1, 3, 5, and 10 minutes after endotracheal intubation were noted. Results: The percentage change in hemodynamic parameters was significant from the baseline value in the propofol group compared to the etomidate and combination group at all the time intervals. The change in hemodynamic parameters from the baseline value was comparable at 2 and 3 minutes post-induction between etomidate and combination group. At other time intervals, the etomidate group tends to have an increase from the baseline while the combination has less significant change from the baseline value compared to etomidate group. Conclusion: The percentage change in the hemodynamic parameters from the baseline value was less in the combination group compared to the etomidate or propofol group. Keywords: Etomidate, propofol, hemodynamics, intubation