To compare thiopentone sodium and etomidate as induction agents during general anaesthesia in patients undergoing surgery for traumatic brain injury

Introduction: Traumatic brain injury (TBI) is a major public health problem and leading cause of morbidity and mortality worldwide. Anaesthetic agents that produce rapid onset of hypnosis and rapid control of the airway without an increase in intracranial pressure and providing haemodynamic stability are preferred. Sodium thiopental and etomidate are commonly used induction agents. Hence, we carried out this study to compare both these drugs with respect to haemodynamic parameters, intraocular pressure (IOP) and bispectral index (BIS) in patients undergoing surgery for TBI. Aims and Objectives: To assess and compare effects of induction of anaesthesia with etomidate and thiopentone sodium in TBI patients with respect to haemodynamic changes, IOP changes and BIS. Material and Methods: Seventy patients of either sex, belonging to American Society of Anesthesiologists I to III (age 18–60 years) posted for emergency craniotomy for TBI were included. The study population will be randomly divided into two groups of 35 patients each. (1) Group T: Patients will be induced with thiopentone 5 mg/kg. (2) Group E: Patients will be induced with etomidate 0.3 mg/kg. IOP will be measured after 1 min of induction agent administration and 5 min after orotracheal intubation. Intraoperative hypotension due to the induction agents will be managed by the use of intravenous ephedrine boluses of 3 mg. The patient will be followed up after 6 h, 24 h and 48 h and 7 days. Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure and BIS were observed and recorded pre- operatively, at the time of intubation, every 1 min for 5 min after intubation and every 5 min for next 15 min. Results: Haemodynamic parameters were found to be stable with etomidate than thiopentone. IOP decreased after etomidate administration. BIS was comparable in both the groups.