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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ann+Card+Anaesth
2015 ; 18
(2
): 172-8
Nephropedia Template TP
gab.com Text
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English Wikipedia
Effect of etomidate and propofol induction on hemodynamic and endocrine response
in patients undergoing coronary artery bypass grafting/mitral valve and aortic
valve replacement surgery on cardiopulmonary bypass
#MMPMID25849685
Kaushal RP
; Vatal A
; Pathak R
Ann Card Anaesth
2015[Apr]; 18
(2
): 172-8
PMID25849685
show ga
INTRODUCTION: The concerns for induction of anaesthesia in patients undergoing
cardiac surgery include hemodynamic stability, attenuation of stress response and
maintenance of balance between myocardial oxygen demand and supply. Various
Intravenous anaesthetic agents like Thiopentone, Etomidate, Propofol, Midazolam,
and Ketamine have been used for anesthetizing patients for cardiac surgeries.
However, many authors have expressed concerns regarding induction with
thiopentone, midazolam and ketamine. Hence, Propofol and Etomidate are preferred
for induction in these patients. However, these two drugs have different
characteristics. Etomidate is preferred for patients with poor left ventricular
(LV) function as it provides stable cardiovascular profile. But there are
concerns about reduction in adrenal suppression and serum cortisol levels.
Propofol, on the other hand may cause a reduction in systemic vascular resistance
and subsequent hypotension. Thus, this study was conducted to compare induction
with these two agents in cardiac surgeries. METHODS: Baseline categorical and
continuous variables were compared using Fisher's exact test and student's t test
respectively. Hemodynamic variables were compared using student's t test for
independent samples. The primary outcome (serum cortisol and blood sugar) of the
study was compared using Wilcoxon Rank Sum test. The P value less than 0.05 was
considered significant. RESULTS: Etomidate provides more stable hemodynamic
parameters as compared to Propofol. Propofol causes vasodilation and may result
in drop of systematic BP. Etomidate can therefore be safely used for induction in
patients with good LV function for CABG/MVR/AVR on CPB without serious cortisol
suppression lasting more than twenty-four hours.