Comparison of hemodynamic effects of etomidate and propofol as an induction agent in patients with LVEF 40% undergoing elective coronary artery bypass grafting surgery – A prospective and randomized study

Authors : Dharmendra Carpenter, Brijesh Soni, Pradeep Kumar Goyal, Mukesh Godara

DOI : 10.18231/j.ijca.2021.048

Volume : 8

Issue : 2

Year : 2021

Page No : 250-256

Background: This study aims to compare the hemodynamic response of two commonly used induction agents Propofol and Etomidate in patients with left ventricular ejection fraction <40% undergoing Coronary Artery Bypass Grafting surgery.
Aim: To compare the effects of Propofol and Etomidate on hemodynamics in terms of heart rate, rhythm, blood pressure, and central venous pressure.
Setting: Narayana Multispeciality Hospital, Jaipur.
Design: Prospective, double-blinded, randomized, hospital based study.
Materials and Methods: 100 patients with LVEF40% scheduled for elective CABG, were randomly assigned to one of the two groups receiving either of the inducing agents, group A (PROPOFOL 2mg/kg) and group B (ETOMIDATE 0.2mg/kg).
Statistical Analysis: Unpaired t-test and Chi square test/Fisher exact test, p<0> Results: HR, SBP, DBP and MAP decreased from post induction 1 min. to post induction 3 min. (fall greater in propofol, p>0.005) then increased from post intubation 1 min. to post intubation 5 min. in both the groups (rise greater in etomidate group, p<0 p=0.001) p=0.002)> Conclusion: Etomidate is superior to propofol in providing hemodynamic stability before and after laryngoscopy and intubation, but less effective in controlling the pressor response to intubation. Therefore, Etomidate can be used as an induction agent with suitable adjuvants to control pressor response to tracheal
intubation in patients undergoing CABG with low LVEF.

Keywords: Coronary artery bypass grafting, Etomidate, LV dysfunction, Propofol, Induction.


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