A comparative study of haemodynamic parameters using Etomidate and Ketofol as induction agents
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 7, Issue 2
Abstract
Background: Etomidate is routinely used for intravenous induction where haemodynamic stability is essential. Ketofol, an ad-mixture of Propofol and Ketamine, which also has a stable haemodynamic profile, is recently being used as an induction agent. We compared the efficacy of Ketofol and Etomidate in terms of haemodynamic stability. Methodology: After ethical committee approval, this prospective randomized double blind study was conducted in seventy patients randomly divided into two groups. Group KP received Inj. ketofol [Inj.propofol 1mg/kg + Inj. Ketamine 0.75mg/kg] whereas Group E received Inj. Etomidate 0.3mg/kg. The vital parameters (HR, SBP, DBP, MAP) of the patient were noted after premedication (baseline), after induction, immediately after intubation (0 minute), from there onwards every 2 minutesutes for a period of 10 minutes and then at 15 minutes. Statistical significance in mean difference was calculated using student’s t test. P value of < 0.05 was regarded as statistically significant and p < 0.001 was taken as highly significant. Results: Both the groups showed statistically significant rise in the heart rate when compared to the baseline immediately after intubation and at 2 minutesutes post intubation (p < 0.05) however there was no statistically significant difference between the two groups in the heart rate at any time interval. Group KP did not show any significant change in the SBP, DBP or MAP at any stage. In Group E, there was statistically significant rise in the SBP (9.5%, p=0.22) as well as DBP (7.6%, p=0.034) at 2 minutesutes post intubation, however no significant change in MAP at any time. The two groups showed statistically significant difference in SBP immediately after intubation (p=0.008) and at 2 minutes postintubation (p=0.006) whereas there was a statistically significant difference in DBP and MAP between the two groups only at 2 minutes post intubation with Group E showing higher values (DBP - p=0.012) (MAP - p=0.035). Conclusion: Ketofol (propofol 1 mg/kg and ketamine 0.75 mg/kg) is an effective and safe alternative to etomidate as an induction agent with superior hemodynamic stability compared to etomidate in patients receiving general anaesthesia.
Authors and Affiliations
Vasanti Prabhakar Kelkar, Abhijith Kumar, Pradnya Muralidhar Kulkarni, Sanhita Jiten Kulkarni
Keywords
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