A randomized clinical trial comparing hemodynamic responses to ketamine-propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery
Introduction : Anesthesia induction is often accompanied by a period of hemodynamic instability, which could be a significant problem in patients with compromised ventricular function. The aim of this study is to compare the hemodynamic responses to etomidate versus a combination of ketamine and pro...
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| Format: | Article |
| Language: | English |
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Termedia Publishing House
2016-10-01
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| Series: | Archives of Medical Science |
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| Online Access: | https://www.termedia.pl/A-randomized-clinical-trial-comparing-hemodynamic-responses-to-ketamine-propofol-combination-ketofol-versus-etomidate-during-anesthesia-induction-in-patients-with-left-ventricular-dysfunction-undergoi,19,28604,1,1.html |
| _version_ | 1818140499572162560 |
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| author | Afshin Gholipour Baradari Abbas Alipour Mohammad Reza Habibi Sajedeh Rashidaei Amir Emami Zeydi |
| author_facet | Afshin Gholipour Baradari Abbas Alipour Mohammad Reza Habibi Sajedeh Rashidaei Amir Emami Zeydi |
| author_sort | Afshin Gholipour Baradari |
| collection | DOAJ |
| description | Introduction : Anesthesia induction is often accompanied by a period of hemodynamic instability, which could be a significant problem in patients with compromised ventricular function. The aim of this study is to compare the hemodynamic responses to etomidate versus a combination of ketamine and propofol (ketofol) for anesthetic induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft (CABG) surgery.
Material and methods : In a double-blind randomized clinical study, a total of 84 patients with ischemic left ventricular dysfunction (EF < 40%) were randomly assigned to two groups (A and B). Patients in group A received etomidate 0.2 mg/kg and a placebo (normal saline); group B received a combination of ketamine (1 mg/kg) and propofol (1.5 mg/kg) at the induction of anesthesia. Two minutes after induction, hemodynamic variables, including systolic, diastolic, mean arterial pressure (SAP, DAP, MAP) and heart rate (HR), were measured immediately before and after the laryngoscopy, and before intubation and post-intubation at 1, 2, and 3 min.
Results: The decrease in all hemodynamic parameters (SBP, DBP, MAP and HR) from induction time to laryngoscopy was greater in the ketofol group (group B) than in the etomidate group (group A) (p < 0.05). The ephedrine prescription rate due to hemodynamic changes was 24.4% (10 patients) and 5% (2 patients) in group B and group A, respectively (p = 0.03).
Conclusions : We found that etomidate provides superior hemodynamic stability as compared to ketofol in patients with left ventricular dysfunction undergoing CABG surgery under general anesthesia. |
| first_indexed | 2024-12-11T10:44:58Z |
| format | Article |
| id | doaj.art-826d470a7d214738983680bc932b7721 |
| institution | Directory Open Access Journal |
| issn | 1734-1922 1896-9151 |
| language | English |
| last_indexed | 2024-12-11T10:44:58Z |
| publishDate | 2016-10-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Archives of Medical Science |
| spelling | doaj.art-826d470a7d214738983680bc932b77212022-12-22T01:10:29ZengTermedia Publishing HouseArchives of Medical Science1734-19221896-91512016-10-011351102111010.5114/aoms.2016.6319328604A randomized clinical trial comparing hemodynamic responses to ketamine-propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgeryAfshin Gholipour BaradariAbbas AlipourMohammad Reza HabibiSajedeh RashidaeiAmir Emami ZeydiIntroduction : Anesthesia induction is often accompanied by a period of hemodynamic instability, which could be a significant problem in patients with compromised ventricular function. The aim of this study is to compare the hemodynamic responses to etomidate versus a combination of ketamine and propofol (ketofol) for anesthetic induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft (CABG) surgery. Material and methods : In a double-blind randomized clinical study, a total of 84 patients with ischemic left ventricular dysfunction (EF < 40%) were randomly assigned to two groups (A and B). Patients in group A received etomidate 0.2 mg/kg and a placebo (normal saline); group B received a combination of ketamine (1 mg/kg) and propofol (1.5 mg/kg) at the induction of anesthesia. Two minutes after induction, hemodynamic variables, including systolic, diastolic, mean arterial pressure (SAP, DAP, MAP) and heart rate (HR), were measured immediately before and after the laryngoscopy, and before intubation and post-intubation at 1, 2, and 3 min. Results: The decrease in all hemodynamic parameters (SBP, DBP, MAP and HR) from induction time to laryngoscopy was greater in the ketofol group (group B) than in the etomidate group (group A) (p < 0.05). The ephedrine prescription rate due to hemodynamic changes was 24.4% (10 patients) and 5% (2 patients) in group B and group A, respectively (p = 0.03). Conclusions : We found that etomidate provides superior hemodynamic stability as compared to ketofol in patients with left ventricular dysfunction undergoing CABG surgery under general anesthesia.https://www.termedia.pl/A-randomized-clinical-trial-comparing-hemodynamic-responses-to-ketamine-propofol-combination-ketofol-versus-etomidate-during-anesthesia-induction-in-patients-with-left-ventricular-dysfunction-undergoi,19,28604,1,1.htmlketofol etomidate hemodynamics propofol ketamine ventricular dysfunction |
| spellingShingle | Afshin Gholipour Baradari Abbas Alipour Mohammad Reza Habibi Sajedeh Rashidaei Amir Emami Zeydi A randomized clinical trial comparing hemodynamic responses to ketamine-propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery Archives of Medical Science ketofol etomidate hemodynamics propofol ketamine ventricular dysfunction |
| title | A randomized clinical trial comparing hemodynamic responses to ketamine-propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery |
| title_full | A randomized clinical trial comparing hemodynamic responses to ketamine-propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery |
| title_fullStr | A randomized clinical trial comparing hemodynamic responses to ketamine-propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery |
| title_full_unstemmed | A randomized clinical trial comparing hemodynamic responses to ketamine-propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery |
| title_short | A randomized clinical trial comparing hemodynamic responses to ketamine-propofol combination (ketofol) versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery |
| title_sort | randomized clinical trial comparing hemodynamic responses to ketamine propofol combination ketofol versus etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery |
| topic | ketofol etomidate hemodynamics propofol ketamine ventricular dysfunction |
| url | https://www.termedia.pl/A-randomized-clinical-trial-comparing-hemodynamic-responses-to-ketamine-propofol-combination-ketofol-versus-etomidate-during-anesthesia-induction-in-patients-with-left-ventricular-dysfunction-undergoi,19,28604,1,1.html |
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