A comparison of anesthetic regimens using etomidate and propofol in patients undergoing first-trimester abortions: double-blind, randomized clinical trial of safety and efficacy

Wu, Jing; Yao, Shanglong; Wu, Zhouyang; Wu, Zhi Yuan; Chu, Shujuan; Xia, Geqing; Deng, Feilong

doi:10.1016/j.contraception.2012.08.014

Cited by 23 publications

(18 citation statements)

References 15 publications

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“…Etomidate has rarely been used in outpatient operations and during examination due to side effects, such as myoclonus and PONV. Etomidate has been observed to be associated with a high (30-40%) incidence of PONV, and the incidence of myoclonus following etomidate use is highly variable (0-70%) (22,23), which is higher than propofol (22). In the present study, the incidence of myoclonus, PONV and injection pain when etomidate combined with propofol was used and injected in different sequences, was investigated.…”

Section: A B Cmentioning

confidence: 99%

Safety and efficacy of etomidate and propofol anesthesia in elderly patients undergoing gastroscopy: A double-blind randomized clinical study

Meng

Cao

Liu

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study is to compare the safety, efficacy and cost effectiveness of anesthetic regimens by compound, using etomidate and propofol in elderly patients undergoing gastroscopy. A total of 200 volunteers (65-79 years of age) scheduled for gastroscopy under anesthesia were randomly divided into the following groups: P, propofol (1.5-2.0 mg/kg); E, etomidate (0.15-0.2 mg/kg); P+E, propofol (0.75-1 mg/kg) followed by etomidate (0.075-0.1 mg/kg); and E+P, etomidate (0.075-0.01 mg/kg) followed by propofol (0.75-1 mg/kg). Vital signs and bispectral index were monitored at different time points. Complications, induction and examination time, anesthesia duration, and recovery and discharge time were recorded. At the end of the procedure, the satisfaction of patients, endoscopists and the anesthetist were evaluated. The recovery (6.1±1.2 h) and discharge times (24.8±2.8 h) in group E were significantly longer compared with groups P, P+E and E+P (P<0.05). The occurrence of injection pain in group P+E was significantly higher compared with the other three groups (P<0.05). In addition, the incidence of myoclonus and post-operative nausea and vomiting were significantly higher in group P+E compared with the other three groups (P<0.05). There was no statistical difference among the four groups with regards to the patients' immediate, post-procedure satisfaction (P>0.05). Furthermore, there was no difference in the satisfaction of anesthesia, as evaluated by the anesthetist and endoscopist, among the four groups (P>0.05). The present study demonstrates that anesthesia for gastroscopy in elderly patients can be safely and effectively accomplished using a drug regimen that combines propofol with etomidate. The combined use of propofol and etomidate has unique characteristics which improve hemodynamic stability, cause minimal respiratory depression and less side effects, provide rapid return to full activity and result in high levels of satisfaction.

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Section: A B Cmentioning

confidence: 99%

Safety and efficacy of etomidate and propofol anesthesia in elderly patients undergoing gastroscopy: A double-blind randomized clinical study

Meng

Cao

Liu

et al. 2016

Experimental and Therapeutic Medicine

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“…In order to reflect the stability and fluctuation of the vital signs, BP, MAP, SPO 2 and HR were monitored, and there were no significant fluctuations during surgical abortion under TEAS. On the other hand, a study showed that under propofol anesthesia, the SPO 2 and MAP of pregnant women dropped significantly . The present study suggests that TEAS intervention could be safer than anesthesia for surgical abortion, but this will have to be compared in a trial.…”

Section: Discussionmentioning

confidence: 70%

“…On the other hand, a study showed that under propofol anesthesia, the SPO 2 and MAP of pregnant women dropped significantly. 23 The present study suggests that TEAS intervention could be safer than anesthesia for surgical abortion, but this will have to be compared in a trial.…”

Section: Discussionmentioning

confidence: 88%

Pain management of surgical abortion using transcutaneous acupoint electrical stimulation: An orthogonal prospective study

Wang

Chen

et al. 2018

J of Obstet and Gynaecol

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AimThis study aimed to evaluate the optimal combination of parameters for the management of pain during surgical abortion using transcutaneous acupoint electrical stimulation (TEAS).MethodsThis study recruited patients scheduled for surgical abortion between October 2014 and August 2015. The treatment protocol was created using three levels for each factor (stimulating time, acupoints, age, and parity). The primary outcomes were intraoperative visual analog scale (VAS), postoperative VAS, cervical relaxation degree and intraoperative blood loss. The secondary outcomes were the vital signs.ResultsStimulation time was associated with intraoperative VAS scores (P < 0.001), acupoints were associated with postoperative VAS scores (P = 0.037), and age was associated with postoperative VAS scores (P < 0.043). Parity (P = 0.025) was associated with heart rate. A comprehensive analysis of the parameters revealed the best levels for each (stimulation time: from 15 min before operation to immediate postoperative; acupoints: SP 6 and LR 3; patient age 25.1–30.0 years; and parity: G≥2P0A≥1). Seven patients did not complete follow‐up. The remaining 135 subjects did not show continuous vaginal bleeding, abdominal pain, fever or any other adverse effect.ConclusionDuring surgical abortion, TEAS stimulation from 15 min before operation to immediate postoperative, SP 6 and LR 3, age 25.1–30.0 years and G≥2P0A≥1 were associated with the best analgesic effect.

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“…21 Also study that favours our results are the study conducted by Jin wu et al, Ye L et al, Mayer et al They all observed that incidence of pain was more with propofol group as compared to etomidate group. 22,23,24 The incidence of myoclonus was more in etomidate group (7%) and no myoclonus was detected in propofol group. Study done by James R minor for procedural sedation in emergency department found that myoclonus was noted in 20% of patient in group E and 1.8% only in group P. 25 In a study done by Alka Lunia et al in 100 adult patient undergoing general anaesthesia.…”

Section: Discussionmentioning

confidence: 96%

A Comparative Study of the Effect of Etomidate and Propofol Induction on Haemodynamic Response and Serum Cortisol Levels in Patients Undergoing Laparoscopic Cholecystectomy

Wahab¹,

Heisnam²,

Nushrat³

et al. 2020

jebmh

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BACKGROUND The choice of an anaesthetic agent for induction of anaesthesia is based mainly on its pharmacodynamic properties. We wanted to compare the effect of etomidate and propofol induction on haemodynamic response, serum cortisol level, and adverse effects in patients undergoing laparoscopic cholecystectomy. METHOD After approval from the institutional ethics committee, eighty-three American Society of Anaesthesiologist (ASA) grade I or II patients of 20-60 yrs. undergoing elective laparoscopic cholecystectomy were enrolled in the study. Patients were allocated randomly to receive either propofol or etomidate for induction of anaesthesia. Anaesthesia was maintained in both the groups with sevoflurane air and oxygen mixture, vecuronium bromide 0.08 mg/Kg for muscle relaxant. RESULTS The mean baseline haemodynamic parameters (SBP, DBP, MAP, HR) are comparable in both the groups. Post induction blood pressure was significantly lower in propofol group as compared to etomidate group. Immediately after intubation surge in blood pressure was more in etomidate group than propofol group. Also there was no difference in mean baseline serum cortisol levels in both the groups. But after induction, serum cortisol level was significantly decreased in etomidate group. However, after 24 hrs. of induction mean serum cortisol level in both the groups returns to baseline value. CONCLUSIONS Etomidate has more stable cardiovascular profile than propofol. It has the added advantage of minimizing induction hypotension which can cause coronary hypoperfusion, dysrhythmia and even cardiac arrest. Etomidate causes temporary reduction in serum cortisol level and this reduction in serum cortisol gets normalized 24 hrs. after induction.

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A comparison of anesthetic regimens using etomidate and propofol in patients undergoing first-trimester abortions: double-blind, randomized clinical trial of safety and efficacy

Cited by 23 publications

References 15 publications

Safety and efficacy of etomidate and propofol anesthesia in elderly patients undergoing gastroscopy: A double-blind randomized clinical study

Safety and efficacy of etomidate and propofol anesthesia in elderly patients undergoing gastroscopy: A double-blind randomized clinical study

Pain management of surgical abortion using transcutaneous acupoint electrical stimulation: An orthogonal prospective study

A Comparative Study of the Effect of Etomidate and Propofol Induction on Haemodynamic Response and Serum Cortisol Levels in Patients Undergoing Laparoscopic Cholecystectomy

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