Hemodynamic Changes following Anesthesia Induction and LMA Insertion with Propofol, Etomidate, and Propofol + Etomidate

Hosseinzadeh, Hamzeh; Golzari, Samad Ej; Torabi, Effat; Dehdilani, Marjan

doi:10.5681/jcvtr.2013.023

Cited by 11 publications

(5 citation statements)

References 13 publications

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“…showed that the MAP in the ET and Groups P + ET was more stable than in the Group P, while after reducing the dose of propofol and adding etomidate as an adjunct, the difference between the groups was not significant between Group ET and Group P + ET in increasing hemodynamic stability. They also stated that the highest blood pressure drop (after LMA insertion) was in the Group P.[ 11 ]…”

Section: Discussionmentioning

confidence: 99%

“…In line with the present study, many previous studies have shown that heart rate in Group P had been significantly reduced compared to Group ET, but there were no difference between P and P + ET groups. [ 11 12 26 ] Another study indicated that the changes in heart rate and SPO 2 in Group P were higher than those in Group ET. [ 22 ] Therefore, propofol may be recommended for patients who require appropriate postoperative cooperation (such as patients with chronic obstructive pulmonary disease) and etomidate may be recommended in patients with hemodynamic problems.…”

Section: Discussionmentioning

confidence: 99%

“…In this double-blind clinical trial, the study population included all present candidates for eye surgery in Feiz hospital from March 21, 2019, to March 19, 2020. Of this population, according to the literature suggesting systolic blood pressure (SBP) standard deviations (SDs) of 12.9 and 19.2 and 11.2 as the minimum difference of the average changes of SBP in in two groups of the study,[ 11 ] we assigned patients (a total of 128 cases) to groups of 32 patients as samples (confidence interval: 95%, power of the test: 80%). To select these samples, we used consecutive sampling for patients who have indications for cataract surgery with general anesthesia and placement of the LMA.…”

Section: Methodsmentioning

confidence: 99%

“…We administered to first group (Group T + M) a combination of midazolam (0.04 mg/kg) and thiopental (2.5 mg/kg) and to second group (Group P) propofol (2.5 mg/kg) alone and to third group (Group ET + P) a combination of etomidate (0.1 mg/kg) and propofol (1 mg/kg) and to fourth group (Group T) thiopental (5 mg/kg) alone. [ 11 18 ]…”

Section: Methodsmentioning

confidence: 99%

“…Etomidate is an IV medication which can be used alone or in combination of other anesthetic drugs to induce anesthesia. [ 11 ] It is more popular for emergency intubation by maintaining hemodynamic stability and minimizing the debilitating effects of cardiopulmonary resuscitation. [ 12 13 ]…”

Section: Introductionmentioning

confidence: 99%

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A Comparative Study of the Effect of Anesthesia Induction with the Use of Four Drug Combinations Including “Propofol,” “Etomidate-Propofol,” “Thiopental,” and “Midazolam-Thiopental” on Hemodynamic Changes during the Insertion of Laryngeal Mask in Eye Surgery

Shetabi¹,

Montazeri²,

Ghoodjani³

2022

Advanced Biomedical Research

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Background: This study aimed to compare the efficacies of four anesthetic induction drugs (thiopental, propofol, midazolam-thiopental, and etomidate-propofol) on cardiovascular response during laryngeal mask airway (LMA) placement in eye surgery. Materials and Methods: The present clinical trial study included 128 patients who were candidates for ophthalmic surgery in four groups. Patients in the first group were given a combination of midazolam (0.04 mg/kg) with thiopental (2.5 mg/kg) (Group T + M). We administered propofol alone (2.5 mg/kg) to patients in the second group (Group P). The third group received a combination of etomidate (0.1 mg/kg) with propofol (1 mg/kg) (ET + P group) and patients in the fourth group received thiopental drug (5 mg/kg) alone (Group T). Then, the stability of patients' hemodynamic parameters before anesthesia was evaluated and compared immediately after anesthesia, 1, 3, and 5 min after LMA placement. Results: There was no significant difference between the four groups in changes in oxygen saturation level (P > 0.05). Furthermore, the difference between decreased systolic blood pressure and diastolic blood pressure over time was not significant in 5 min in both Groups T + M and T (P > 0.05). In addition, the stability of these two groups was higher than the other two groups (P < 0.05) and the most unstable group was Group P. The changes pulse ratein the P group were significant (P < 0.05). Conclusion: According to the results of the current study, thiopental and Midazolam can be used as an effective induction compound to facilitate LMA insertion with higher hemodynamic stability compared to propofol alone, propofol and etomidate, and thiopental alone.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Comparative Study of the Effect of Anesthesia Induction with the Use of Four Drug Combinations Including “Propofol,” “Etomidate-Propofol,” “Thiopental,” and “Midazolam-Thiopental” on Hemodynamic Changes during the Insertion of Laryngeal Mask in Eye Surgery

Shetabi¹,

Montazeri²,

Ghoodjani³

2022

Advanced Biomedical Research

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Correlation of MDR1 gene polymorphisms with anesthetic effect of sevoflurane–remifentanil following pediatric tonsillectomy

Shi

Zhang²,

Zhang³

et al. 2017

Medicine

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Background:The motive of this study was to investigate the collaboration between MDR1 gene polymorphisms and anesthetic effects following pediatric tonsillectomy.Methods:All together 178 children undergoing tonsillectomy with preoperative sevoflurane–remifentanil anesthesia were selected. In order to determine MDR1 gene polymorphisms of 3435C > T, 1236C > T, and 2677G > T/A, polymerase chain reaction–restriction fragment length polymorphism was used. Mean arterial pressure (MAP), diastolic blood pressure (DBP), systolic blood pressure (SBP), and heart rate (HR) at T0 (5 mins after the repose), T1 (0 min after tracheal intubation), T2 (5 mins after the tracheal intubation), T3 (0 min after the tonsillectomy), T4 (0 min after removal of the mouth-gag) and T5 (5 min after the extubation) were observed. The visual analog scale (VAS), the face, legs, activity, cry, and consolability (FLACC) pain assessment, and Ramsay sedation score were recorded after the patients gained consciousness. The adverse reactions were also observed.Results:As compared to the CT + TT genotype of MDR1 1236C > T, the time of induction, respiration recovery, eye-opening, and extubation of children with the CC genotype was found to be shorter (all P <.05); the MAP, SBP, DBP, and HR were significantly reduced at T5 in children that possessed the CC genotype (all P <.05), the VAS at postoperative 1, 2, 4, and 8 hours and Ramsay sedation score were decreased, while the FLACC score increased (all P <.05). It was found that the adverse reaction rate was lower in children bearing the CC genotype (P <.05).Conclusion:It could be concluded that anesthetic effect in patients with the MDR1 1236C > T CC genotype was found to be superior to those carrying the CT + TT genotype.

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Propofol Combined with Fentanyl Is Superior to Propofol Alone in Sedation Protocols for Painless Gastrointestinal Endoscopy

Chang

Yang

2021

Journal of Nanomaterials

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Sufficient propofol or fentanyl doses necessary to prevent the response to skin incision do not necessarily reduce hemodynamic responses during surgery. The purpose of this study was to characterize the pharmacodynamic interaction between propofol and fentanyl with respect to the sedative effects and safety during painless gastrointestinal endoscopy. From October 2018 to October 2020, 200 patients undergoing painless gastrointestinal endoscopy in our department’s outpatient or inpatient clinic were selected and randomly divided into a control group and an observation group, 100 patients per group. Prior to surgery, the patients in the two groups were required to be connected to an electrocardiogram monitor and then were instructed to lie on the left side and receive continuous oxygen infusion of 2-3 L/min with a nasal cannula. The control group was injected with propofol injection (100 mg/min). The observation group was given fentanyl intravenous injection at a dose of 0.1 μg/kg followed by propofol injection (100 mg/min). Painless gastrointestinal endoscopy was performed after the patients entered a sleep state and the eyelash reaction disappeared. Outcome analysis was performed on preoperative and intraoperative hemodynamic indicators, including heart rate, blood oxygen saturation, dose of propofol, time for endoscopy, recovery time, hospitalization after recovery, Montreal Cognitive Assessment (MoCA) score, and Mini-Mental State Examination (MMSE) score. The incidence rate of adverse reactions in the observation group was 6%, which was notably lower than that of the control group (18%). The total response rate of the observation group was 98%, which was significantly higher than that of the control group (90%) ( P < 0.05 ). The intraoperative heart rate and blood oxygen saturation of the observation group were higher than those of the control group ( P < 0.0 ss ). The patients receiving sedation with propofol plus fentanyl had fewer doses of propofol and shorter recovery time than those receiving propofol alone ( P < 0.05 ). It was also revealed that the patients receiving sedation with propofol plus fentanyl exhibited more MoCA and MMSE scores than those receiving propofol alone 30 min after sedation during painless gastrointestinal endoscopy. Taken together, sedation with propofol combined with fentanyl was more effective and safer than that with propofol alone in painless gastrointestinal endoscopy, which can ensure a wake-up state, stable breathing cycle, and better gastrointestinal painless procedure.

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Hemodynamic Changes following Anesthesia Induction and LMA Insertion with Propofol, Etomidate, and Propofol + Etomidate

Cited by 11 publications

References 13 publications

A Comparative Study of the Effect of Anesthesia Induction with the Use of Four Drug Combinations Including “Propofol,” “Etomidate-Propofol,” “Thiopental,” and “Midazolam-Thiopental” on Hemodynamic Changes during the Insertion of Laryngeal Mask in Eye Surgery

A Comparative Study of the Effect of Anesthesia Induction with the Use of Four Drug Combinations Including “Propofol,” “Etomidate-Propofol,” “Thiopental,” and “Midazolam-Thiopental” on Hemodynamic Changes during the Insertion of Laryngeal Mask in Eye Surgery

Correlation of MDR1 gene polymorphisms with anesthetic effect of sevoflurane–remifentanil following pediatric tonsillectomy

Propofol Combined with Fentanyl Is Superior to Propofol Alone in Sedation Protocols for Painless Gastrointestinal Endoscopy

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