M. M. Hossain, M. Alam, Suraya Akter, Md Pervez Altaf Hussain
{"title":"冠脉搭桥术患者麻醉诱导时依托咪酯与异丙酚血流动力学稳定性的比较","authors":"M. M. Hossain, M. Alam, Suraya Akter, Md Pervez Altaf Hussain","doi":"10.3329/jbsa.v34i1.67571","DOIUrl":null,"url":null,"abstract":"Background: Maintenance of hemodynamic stability during induction and obtundation of intubationstress response are the prime consideration of general anaesthesia.\nAims: The purpose of the study is to compare the hemodynamic effects of etomidate and propofol duringinduction and intubation in patients undergoing Coronary Artery Bypass Graft Surgery(CABG).\nMaterials and Methods: This prospective, double-blind randomized clinical trial, total eighty patientswere randomly allocated and divided into two groups based on the induction agent used for anaesthesia(etomidate group or E group) and (propofol group or P group). Heart rate(HR), Mean Arteriolar Bloodpressure(MAP), Cardiac Output (CO) & Cardiac Index(CI) were recorded at preoperative Baseline(T1), atpremedication(T2), at induction(T3), at intubation (T4), 1 min after induction(T5), 3 min after induction(T6),5 min after induction(T7). The use of vasopressors was also recorded, required for both the groups.\nResults: Before induction, there was no significant difference in hemodynamics between the groups (p>.05). At induction, intubation & up to 5 min after induction thereafter all the hemodynamic parameterswere significantly different from baseline value in both groups (p < .001). During the comparison betweentwo group, it was noted that, in P group, propofol caused pronounced reduction of HR, MAP, CO & CI incomparison to E group, at induction(T3), at intubation (T4), 1 min after induction(T5), 3 min afterinduction(T6). The use of vasopressors was also in higher incidences in P group than E group.\nConclusion: This study confirms that Etomidate provides a stable hemodynamic condition in contextwith propofol during induction, intubation & immediate post induction period and this hemodynamicstability can improve the clinical outcomes in patients undergoing CABG.\nJBSA 2021; 34(1): 43-49","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"70 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2021-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Haemodynamic Stability of Etomidate versus Propofol for Induction of Anaesthesia in Patients undergoing Coronary Artery Bypass Graft Surgery\",\"authors\":\"M. M. Hossain, M. Alam, Suraya Akter, Md Pervez Altaf Hussain\",\"doi\":\"10.3329/jbsa.v34i1.67571\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Maintenance of hemodynamic stability during induction and obtundation of intubationstress response are the prime consideration of general anaesthesia.\\nAims: The purpose of the study is to compare the hemodynamic effects of etomidate and propofol duringinduction and intubation in patients undergoing Coronary Artery Bypass Graft Surgery(CABG).\\nMaterials and Methods: This prospective, double-blind randomized clinical trial, total eighty patientswere randomly allocated and divided into two groups based on the induction agent used for anaesthesia(etomidate group or E group) and (propofol group or P group). Heart rate(HR), Mean Arteriolar Bloodpressure(MAP), Cardiac Output (CO) & Cardiac Index(CI) were recorded at preoperative Baseline(T1), atpremedication(T2), at induction(T3), at intubation (T4), 1 min after induction(T5), 3 min after induction(T6),5 min after induction(T7). The use of vasopressors was also recorded, required for both the groups.\\nResults: Before induction, there was no significant difference in hemodynamics between the groups (p>.05). At induction, intubation & up to 5 min after induction thereafter all the hemodynamic parameterswere significantly different from baseline value in both groups (p < .001). During the comparison betweentwo group, it was noted that, in P group, propofol caused pronounced reduction of HR, MAP, CO & CI incomparison to E group, at induction(T3), at intubation (T4), 1 min after induction(T5), 3 min afterinduction(T6). 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引用次数: 0
摘要
背景:维持诱导过程中的血流动力学稳定性和消除插管应激反应是全麻的首要考虑因素。目的:本研究的目的是比较依托咪酯和异丙酚在冠状动脉搭桥手术(CABG)患者诱导和插管期间的血流动力学影响。材料与方法:本前瞻性双盲随机临床试验,共80例患者随机分为两组,根据麻醉诱导剂(依托咪酯组或E组)和(异丙酚组或P组)。分别在术前基线(T1)、用药前(T2)、诱导时(T3)、插管时(T4)、诱导后1分钟(T5)、诱导后3分钟(T6)、诱导后5分钟(T7)记录心率(HR)、平均动脉压(MAP)、心输出量(CO)和心脏指数(CI)。还记录了两组所需的血管加压药的使用情况。结果:诱导前,两组间血流动力学差异无统计学意义(p> 0.05)。两组在诱导时、插管时以及诱导后5分钟内的所有血流动力学参数均与基线值有显著差异(p < 0.001)。在两组比较中发现,P组在诱导(T3)、插管(T4)、诱导后1 min (T5)、诱导后3 min (T6)时,异丙酚使HR、MAP、CO、CI较E组明显降低。P组血管加压药物的使用也高于E组。结论:本研究证实依托咪酯在异丙酚背景下在诱导、插管和诱导后立即提供稳定的血流动力学条件,这种血流动力学稳定性可以改善CABG患者的临床结果。JBSA 2021;34 (1): 43-49
Comparison of Haemodynamic Stability of Etomidate versus Propofol for Induction of Anaesthesia in Patients undergoing Coronary Artery Bypass Graft Surgery
Background: Maintenance of hemodynamic stability during induction and obtundation of intubationstress response are the prime consideration of general anaesthesia.
Aims: The purpose of the study is to compare the hemodynamic effects of etomidate and propofol duringinduction and intubation in patients undergoing Coronary Artery Bypass Graft Surgery(CABG).
Materials and Methods: This prospective, double-blind randomized clinical trial, total eighty patientswere randomly allocated and divided into two groups based on the induction agent used for anaesthesia(etomidate group or E group) and (propofol group or P group). Heart rate(HR), Mean Arteriolar Bloodpressure(MAP), Cardiac Output (CO) & Cardiac Index(CI) were recorded at preoperative Baseline(T1), atpremedication(T2), at induction(T3), at intubation (T4), 1 min after induction(T5), 3 min after induction(T6),5 min after induction(T7). The use of vasopressors was also recorded, required for both the groups.
Results: Before induction, there was no significant difference in hemodynamics between the groups (p>.05). At induction, intubation & up to 5 min after induction thereafter all the hemodynamic parameterswere significantly different from baseline value in both groups (p < .001). During the comparison betweentwo group, it was noted that, in P group, propofol caused pronounced reduction of HR, MAP, CO & CI incomparison to E group, at induction(T3), at intubation (T4), 1 min after induction(T5), 3 min afterinduction(T6). The use of vasopressors was also in higher incidences in P group than E group.
Conclusion: This study confirms that Etomidate provides a stable hemodynamic condition in contextwith propofol during induction, intubation & immediate post induction period and this hemodynamicstability can improve the clinical outcomes in patients undergoing CABG.
JBSA 2021; 34(1): 43-49