Haemodynamic effects of etomidate, propofol and their combination on induction and intubation: A prospective randomized clinical trial

Introduction and Aims: Co-induction benefits of etomidate-lipuro and propofol have been studied in previous literatures.Here we tested the hypothesis that combination of etomidate and propofol have better haemodynamic stability during induction and intubation than their individual effect in patients undergoing surgeries under general anaesthesia.Materials and Methods: Sixty American Society of Anesthesiologist (ASA) I and II patients scheduled for surgeries under general anaesthesia were randomly allocated into three groups of twenty each.Patients in group E and P received 20ml of the study drug {Inj etomidate 0.3mg/kg in group E, inj.propofol 2mg/kg in group P} intravenously over 1minute during induction.While those in group EP, received 20ml of 1:1 mixture of etomidate and propofol intravenously over 1 minute during induction.Depth of anaesthesia was monitored using bispectral index (BIS).ANOVA and Chi-square test were used for statistical analysis.Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial Pressure (MAP) during induction and intubation were observed as primary objectives and incidence of pain on injection and myoclonus were observed as secondary outcome.Results: Demographic characteristics were indistinguishable in all the three groups.The gradient of fall in SBP, DBP, MAP and HR was more in propofol group.Group EP had better haemodynamic stability during induction and intubation.Incidence of pain on injection was relatively higher (60%) in group P and myoclonus was observed only in etomidate group.Conclusions: The 1:1 mixture of etomidate and propofol provides a better haemodynamic stability compared to either etomidate or propofol alone.Hence it can be preferred as a cost effective induction agent of choice.