The Haemodynamic Effects of Thiopentone/Propofol and Combined use of Low Dose Thiopentone and Propofol on Induction and Intubation - A Three Modality Comparative Study

Abstract

Introduction: Induction, Laryngoscopy and Intubation are the points at which haemodynamic changes occur during conduct of anaesthesia, with such changes leading to deleterious systemic effects in vulnerable patients. This study was conducted to compare the haemodynamic effects on induction, and intubation with endotracheal tube with conventional doses of thiopentone and propofol separately and with combined use of low dose of thiopentone and propofol. Material and methods: The study was conducted on 90 patients of ASA Grade-I and II, and of Age between 20-50 years posted for Elective Surgery. The 90 patients were randomly assigned to three groups of 30 each. Thiopentone (5mg/kg), Propofol (2.5mg/kg) or A combination of low dose of both Thiopentone (2.5mg/kg) and Propofol (1.5mg/kg) was used as induction agent in Groups-I, II and III respectively. Heart Rate and Blood Pressure were measured non-invasively at various (Five) times-At Pre-induction, one minute after the last injection of induction drug i.e., before the performance of Laryngoscopy and Endotracheal tube placement, and at First, Third and Fifth minute of Endotracheal tube placement. Results: The adjusted mean values of Systolic blood pressure, Diastolic blood pressure and Heart rate were assessed by Paired comparisons, by considering the variable of time. All changes were significantly different between Groups I and II. Moreover, changes in systolic and diastolic blood pressures were significantly different between Groups I and III. They were not significant for Heart rate. No significant difference was noted between Groups II and III; showing that in these groups the haemodynamic changes were small during drug injection, Laryngoscopy and Intubation as well as until five minutes after Endotracheal placement. Conclusion: The Combined use of low dose of Thiopentone and Propofol (Group-III) for anaesthetic induction and Intubation caused less Haemodynamic changes than the higher individual dose of either alone.This modality of Anaesthesia induction may have clinical importance for the Elderly patients as well as those with Hypertension and Heart diseases and those belonging to ASA Grade-III and IV.

Comparison of Sevoflurane Versus Propofol for Tracheal Intubation in Children

“…Propofol has a shorted induction time thereby provides smooth and rapid induction and hence rapid recovery. It also reduces muscle tone and thereby reduces laryngeal reflexes that makes it suitable for tracheal intubation without using muscle relaxants 15,16 .…”