Comparative study of Thiopentone and Propofol for induction of anaesthesia in adult population- a randomized clinical trial

Background

Modern medicine relies on general anesthesia. However, due to climate change and geopolitical instability, medicine shortages and supply chain disruptions are having a growing impact on the global healthcare environment. Applying high reliability organization (HRO) principles, healthcare systems must ensure consistent access to key anaesthetic agents. To assess clinical results and implications for sustainable anaesthetic procedures, this study compares thiopentone with propofol as a case study.

Methods

A Prospective, randomised, single-center cohort study. 190 adult patients in the age group of 18–70 years scheduled for different surgical procedures under general anaesthesia were carried out at a tertiary care hospital (Department of Anaesthesiology, SKIMS Medical College and Hospital, Srinagar). Patients were randomly assigned to either propofol or thiopentone to induce anesthesia. Along with qualitative markers such induction smoothness, recovery, and consciousness levels, hemodynamic data such as heart rate, systolic and diastolic blood pressure, and breathing rate were examined.

Results

Both drugs were clinically efficacious and safe. In terms of quicker induction, easier recovery, and general patient satisfaction, propofol performed better (90 % vs. 85 %). It dramatically lowered systolic blood pressure (from 129 ± 11 to 102 ± 9.9 mmHg) and heart rate (from 90 ± 15 to 80 ± 13 beats/min). On the other hand, thiopentone also decreased blood pressure and heart rate, but less significantly. Group differences in respiratory patterns revealed varying physiological reactions.

Conclusion

Although thiopentone and propofol both works well to induce anesthesia, propofol is more patient-acceptable and offers better hemodynamic stability. However, in environments with limited resources, thiopentone is a more practical choice due to its simpler availability and cheaper cost. To improve system resilience—a crucial quality of high reliability organizations functioning under the strains of global supply chain volatility—this case study emphasizes the need of preserving flexibility and redundancy in anesthesia protocols.

Trial registration

The trial was registered prospectively in the Clinical Trial Registry of India (CTRI/2023/02/049,428) registered on 03/02/2023. The first subject was recruited on 05/02/2023.