A comparison of haemodynamic effects between induction agents propofol and etomidate in patients undergoing lumbar spinal surgeries

It was a parallel group, double blind, randomised controlled study wherethe goal was to compare the haemodynamic effects of Propofol and Etomidate asinduction agents in lumbar spine surgeries. 70 patients of ASA Grade I & II of either sex, agedbetween 20 to 65years undergoing elective lumbar spine surgery undergeneral anesthesia were randomly divided into two groups: Group P received BISguided infusion propofol @ 0.5 mg/kg/min and group E received BIS guidedinfusion etomidate @0.05mg/kg/min. Heart rate(HR), oxygen saturation (Spo2),mean arterial pressure(MAP), cardiac output(CO), stroke volume variation(SVV)were measured at preoperative baseline level, before giving premedication, atinduction, intubation, then at 1 min, 3mins & 5 mins following intubation.

 Demographic profilesand baseline parameters of the patients with regards to HR, MAP, CO, SVV, Spo2and BIS of the patients of both the groups were comparable.

 Till intubation HR, COand MAP were decreased in both the groups but the fall was sharper in P group.1min following intubation, there was transient rise in all these parameterswhich came down around baseline in P group but remained at higher level in Egroup following 3 & 5 mins after intubation. Rescue drugs were required incase of E group subjects. SVV was not affected by study drugs.

Based on the results derived from this study, it can beconcluded that when we compared Propofol & Etomidate for BIS guidedinduction in lumbar spine surgeries, the hemodynamic surge with etomidatelasted for a longer period, whereas, in propofol group hemodynamic status wasmaintained within normal range. So, we can say, though, etomidate is a superiorinduction agent in cardiac surgeries, role of etomidate as induction agent inspinal surgery is debatable & not cost effective.