Evaluation of Pain on Injection, Haemodynamics and Postoperative Nausea and Vomiting Following Induction With Propofol, Etomidate-Lipuro and Coinduction With Propofol + Etomidate Lipuro- A Comparative Study

Abstract

BACKGROUND Induction of general anaesthesia is the most important phase, which can be achieved by various inhalational and intravenous agents. An ideal inducing agent for general anaesthesia should have haemodynamic stability and minimal respiratory depression, rapid clearance and minimal side effects. Propofol is the most commonly used induction agent, as it has rapid onset and early recovery due to short half-life and rapid elimination from the blood circulation. Propofol is associated with pain [1] during induction, which is sometimes very distressing to patients and it can also cause haemodynamic instability. The aim of this study was to compare the incidence of pain on injection, haemodynamic changes following induction and the incidence of PONV using etomidate-lipuro, propofol and coinduction with propofol and etomidate-lipuro. MATERIALS AND METHODS This is a randomised, controlled trial. A total of 90 patients with ASA I and II were randomly allocated into three groups, i.e. Group E, Group P and Group P + E. Group E patients received etomidate 0.3 mg/kg, Group P patients received propofol 2 mg/kg and Group P + E received propofol 1 mg/kg + etomidate 0.2 mg/kg for induction of anaesthesia. The incidence of pain on injection was observed during the infusion of drugs, haemodynamic changes including heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure were accessed after induction and after intubation at various time intervals. The incidence of PONV was accessed for 24 hrs. postoperatively. RESULTS Comparing the three groups, it was seen that the incidence of pain on injection was maximum in propofol group followed by etomidate group and was reduced to a highly significant level in etomidate + propofol group (p < 0.0001). The haemodynamic (systolic, diastolic and mean blood pressures, heart rate) changes were minimal in Propofol + Etomidate group. Etomidate group was associated with higher incidence of postoperative nausea and vomiting.