Publications

Background: Induction of anaesthesia and endotracheal intubation are associated with adverse
haemodynamic effects which are detrimental in hypertensive patients. Although etomidate is found to be
a cardio stable induction agent, its advantages in hypertensive patients are not yet investigated. Aim of the present study is to
compare the haemodynamic parameters following induction of anaesthesia with etomidate and propofol in normotensive and
hypertensive patients.
Methods: In a prospective comparative study, 120 patients aged 18 to 60 years, of both sex and ASA status I & II posted for
elective surgery under general anaesthesia were divided into 4 groups of 30 each. Anaesthesia was induced with either
propofol or etomidate. Heart rate(HR), Systolic Blood Pressure(SBP), Diastolic Blood Pressure(DBP), Mean Arterial
Pressure(MAP) and SpO2 were noted down at baseline, pre-induction, after induction, at laryngoscopy and 1, 3 & 5 minutes
post intubation.
Results: There was a signicant fall in HR after induction with propofol which was more in the hypertensive group. After
intubation, a rise in HR was observed in all 4 groups which returned to baseline by 5 minutes. A fall in MAP, SBP and DBP were
observed in all the groups following induction, which shooted up after intubation. The fall in MAP with propofol was
signicantly higher when compared to etomidate which offered stable haemodynamic conditions.
Conclusion: The present study suggests that induction of anaesthesia with etomidate is associated with better stability of MAP
in normotensive as well as hypertensive patients when compared with propofol. However, HR is better maintained with
propofol. Thus there is no clear evidence supporting induction by etomidate in hypertensive patien