Comparison of the hemodynamic effects of etomidate between hypertensive and normotensive patients

Year 2014, , 164 - 168, 01.06.2014

Taner Çiftçi Hayrettin Daşkaya Sinan Uzman Yavuz Gün Mehmet Toptaş Ferda Yılmaz İnal Mustafa Demir

https://doi.org/10.5799/ahinjs.01.2014.02.0383

Abstract

Objective: Comparison of the hemodynamic effect of ethomidate induction in normotensive and hypertensive patients. Methods: Forty ASA 1-2 patients were included. After informed consent were obtained, patients were divided into two group; Group H: Hypertensive patients, Group N: Normotensive patients. Fentanile and midazolam were administrated for premedication. Anesthesia induction was performed by etomidate 0.3 mg/kg and rocuronium 0.6 mg/kg. Arterial pressures and heart rates were measured at certain intervals: control, pre-intubation and 1, 3 and 5 min post-intubation. Myoclonic movements and hemodynamic parameters were noted by an anesthetist who was masked to the groups. Results: Hemodynamic parameters were higher in hypertensive patients but were in clinically tolerable limits. Conclusion: No hemodynamic instability was observed in anesthesia induction with ethomidate in neither hypertensive nor normotensive patients. J Clin Exp Invest 2014; 5 (2): 164-168

Keywords

hemodynamic effect, ethomidate, hypertension, normotension

Comparison of the hemodynamic effects of etomidate between hypertensive and normotensive patients

Abstract

Amaç: Etomidat ile anestezi indüksiyonunun hipertansif ve normotansif hastalarda hemodinamik etkilerini karşılaştırmayı amaçladık. Yöntemler: Etik komite onayı ve hastaların yazılı ve sözlü onamları alındıktan sonra genel anestezi altında çeşitli elektif cerrahi girişim uygulanacak olan 40 ardışık ASA I-II hasta çalışmaya alındı. Hastalar rastgele 2 gruba ayrıldı: Grup H (Hipertnasif hastalar), Grup N (Normotansif hastalar). Hastalar anestezi indüksiyonundan önce fentanil ve midazolam ile premedike edildi. Anestezi indüksiyonu etomidat 0.3 mg/kg ve rokuornyum 0.6 mg/kg ile yapıldı. Arteriyal basınçlar ve kalp hızı şu zamanlarda ölçüldü: kontrol, entübasyon öncesi ve entübasyondan 1, 3, 5 dakika sonra. Grup ayrımından habersiz bir anestezist tarafından miyoklonik hareketler ve hemodinamik parametreler kaydedildi. Bulgular: Hemodinamik parametreler tüm dönemlerde hipertansif hastalarda daha yüksekti fakat kabul edilebilir klinik sınırlar içindeydi. Sonuç: Ne hipertansif ne de normotansif hastalarda anestezi indüksiyonunda etomidatla hemodinamik instabilite yoktu.

Keywords

Hemodinamik etki, etomidat, hipertansiyon, normotansiyon

References

• Joint National Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Institutes of Health, 2003.
• Hanada S, Kawakami H, Goto T, Morita S. Hyper- tension and anesthesia. Curr Opin Anaesthesiol 2006;19:315-319.
• Hassan MA, Prys-Roberts C. Anesthesia and chronic hypertension. Middle East J Anesthesiol 1991;11:119- 146.
• Barash PG, Cullen BF, Stoelting RK. Clinical Anesthe- sia, 5th Ed; Philadelphia; Lippincott Williams & Wilkins, 2006; p. 344-345.
• Doenicke A. Etomidate, a new intravenous hypnotic. Acta Anaesthesiol Belg 1974;25:307-315.
• Wolfson AB. Harwood-Nuss’ Clinical Practice of Emer- gency Medicine, 4th Ed; Portland; Lippincott Williams & Wilins, 2005; p. 1150-1153.
• Gooding JM, Weng JT, Smith RA, et al. Cardiovascular and pulmonary response following etomidate induc- tion of anesthesia in patients with demonstrated car- diac disease. Anesth Analg 1979;058:40-41.
• Forbes AM, Dally FG. Acute hypertension during in- duction of anaesthesia and endotracheal intubation in normotensive man. Br J Anaesth 1970;42:618-624.
• Onat A. Risk factors and cardiovascular disease in Tur- key. Atherosclerosis 2001;156:1-10
• Singh R, Choudhury M, Kapoor PM, Kiran U. A ran- domized trial of anesthetic induction agents in pa- tients with coronary artery disease and left ventricular dysfunction. Ann Card Anaesth 2010;13:217-223.
• Zhang GH, Sun L. Peri-intubation hemodynamic changes during low dose fentanyl, remifentanil and sufentanil combined with etomidate for anesthetic in- duction. Chin Med J 2009;122:2330-2334.