Comparison Of Cardiovascular Response To Laryngoscopy And Tracheal Intubation After Induction Of Anesthesia By Propofol And Etomidate

Objective: Etomidate and Propofol are common anesthetic agents.These twokinds of sedative drugs belong to the barbiturates.Propofol is a kind of fast effectiveshort-acting intravenous anesthetics, wake up quickly and completely, withoutaccumulation, after continuous infusion is widely used in anesthesia induction,anesthesia, commonly used in surgery ICU sedation and anesthesia. Etomidatesynthesized in1964and recommended in clinical practice in1972, this kind ofmedicine is the ramification of imidazoles, is hypnotic sedative narcotics, anesthesiainduction and wake up fast, relatively safe, so the clinical application.Along with theincreasing range of patients with general anesthesia,endotracheal intubation canprovide a safe airway during the operation,laryngoscopy also on the rise.The sideeffects of tracheal intubation and Iaryngoscopy including cardiovascularreaction.Previous studies say that Etomidate can be used in patients with limitedhemodynamic reserve and Propofol can lead to more hemodynamic instabilities. Thisstudy was performed to explore the cardiovascular response during the induction ofanesthesia with Etomidate or for comparison, Propofol in burn patients surgeries.Materials and Methods: We select50cases of burn patients, including patients19-62years of age.50patients with burns gender composition is33male and17female.Patients in51kg to86kg.They have no basic diseases.Patients withouthypertension,cerebral infarction,heartless renal insufficiency,without diabetes,adrenal disease,long-term high-dose glucocorticoid treatment.They were burned unfortunately in2013, burn depth is II-III degrees, burn area of35%to70%, these patients have different degrees of burn on head and face, but have no mental disorder and severe respiratory damage.The50patients allergic to anestheticwithout history. ASA I (American Society of Anaesthesiologists),preoperative understanding patient medicine history and general situation,general information(gender,age,weight and body mass index),blood routine,liver and kidney function,electrolyte,conventional electrocar diogram and the sternum.Two groups of patients in the trials by routine fasting8hours before the surgery,the drink4hours,30minutes atropine0.5mg preoperative intramuscular injection,Phenobarbital sodium100mg of preoperative intramuscular injection30minutes. Patients were randomly divided into two groups, group A with etomidate (0.3mg/kg), group B with propofol (2-2.5mg/kg), and observe them before laryngoscopy and1minute after anesthesia induction,3minutes,5minutes,10minutes of cardiovascular reaction, their cardiovascular reactions include: systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SPO2).Results: There were no statistical differences between both groups regardinggender, age, body mass index, and laryngoscopic grade of patients (P>0.05). Changesof SBP in the group B was significantly higher (P=0.019). Furthermore, changes ofthe DBP was significantly higher in the group B (P=0.001). The changes of MAP washigher in group B (P=0.008). Hypotension happened in26.1%of group B and8%ofgroup A (P=0.09). There were no significant differences among groups A and B interms of HR (P=0.47) and O2saturation (P=0.21), tachycardia (P=0.6), bradycardia(P=0.66).Conclusion: Since, patients receiving Etomidate have more stable hemodynamiccondition, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterialpressure (MAP) are stable,patients can reduce cardiovascular reaction,so if therewould be no contraindications, it could be preferred over Propofol for laryngoscopytracheal intubation general anesthesia.Etomidate used to laryngoscopy and inducedendotracheal intubation anesthesia relativelysafe,convenient,is ideal for burn patientsand patients with cardiovascular drugs.