A COMPARATIVE EVALUATION OF HEMODYNAMIC CHARACTERISTICS OF THE THREE INDUCTION AGENTS – ETOMIDATE, THIOPENTONE AND PROPOFOL

BACKGROUND: Induction is an important step, while conducting general anaesthesia.Patients are susceptible to hemodynamic lability at the time of induction.Thus, an agent with least effect on hemodynamics would be the agent of choice.AIMS AND OBJECTIVE: To evaluate the hemodynamic effects of etomidate in comparison to those of thiopentone and propofol during induction of general anaesthesia.SETTINGS AND DESIGN: The study was conducted in the department of anaesthesia of SRMS IMS, over a period of one year from June 2013-2014, on patients undergoing elective surgery under general anaesthesia.MATERIAL AND METHODS: 105 adult patients aged 18 -50 years, belonging to ASA grade 1 and 2, undergoing elective surgery under general anaesthesia, were divided randomly into three groups of 35 patients each.Group A patients were induced with injection thiopentone sodium 5 mg/kg, Group B with injection propofol 2mg/kg and Group C with injection etomidate 0.3 mg/kg intravenously.STATISTICAL ANALYSIS: Data are presented as mean and standard deviation.The statistical analysis was performed using SPSS version 20.A "p" value of less than 0.05 was taken as significant.RESULTS: There was no significant change in mean heart rate at one, two and three minute after induction as compared with the mean heart rate at the time of induction in all the groups(p>0.05).In Groups A and B there was a significant fall in systolic blood pressure, diastolic blood pressure and mean arterial pressure at one, two and three minute after induction, as compared to the induction value (p<0.05).In Group C however, there was no significant change in systolic, diastolic and mean arterial pressure (p>0.05).CONCLUSION: Etomidate offers superior hemodynamic stability during induction compared to thiopentone and propofol.Thus etomidate is a better induction agent for general anaesthesia.