Etomidate Anesthesia during ERCP Caused More Stable Haemodynamic Responses Compared with Propofol: A Randomized Clinical Trial

Jin-Chao Song, Zhi-Jie Lu, Ying-Fu Jiao, Bin Yang, Hao Gao, Jinmin Zhang, Wei-Feng Yu, Jin-Chao Song, Zhi-Jie Lu, Ying-Fu Jiao, Bin Yang, Hao Gao, Jinmin Zhang, Wei-Feng Yu

Abstract

Background: Propofol may result in hypotension and respiratory depression, while etomidate is considered to be a safe induction agent for haemodynamically unstable patients because of its low risk of hypotension. We hypothesized that etomidate anesthesia during ERCP caused more stable haemodynamic responses compared with propofol. The primary endpoint was to compare the haemodynamic effects of etomidate vs. propofol in ERCP cases. The secondary endpoint was overall survival.

Methods: A total of 80 patients undergoing ERCP were randomly assigned to an etomidate or propofol group. Patients in the etomidate group received etomidate induction and maintenance during ERCP, and patients in the propofol group received propofol induction and maintenance. Cardiovascular parameters and procedure-related time were measured and recorded during ERCP.

Results: The average percent change to baseline in MBP was -8.4±7.8 and -14.4±9.4 with P = 0.002, and in HR was 1.8±16.6 and 2.4±16.3 with P = 0.874 in the etomidate group and the propofol group, respectively. MBP values in the etomidate group decreased significantly less than those in the propofol group (P<0.05). The ERCP duration and recovery time in both groups was similar. There was no significant difference in the survival rates between groups ( p = 0.942).

Conclusions: Etomidate anesthesia during ERCP caused more stable haemodynamic responses compared with propofol.

Keywords: Etomidate anesthesia; propofol.

Conflict of interest statement

Conflicts of Interest: The authors declare no conflicts of interest. The study complies with current ethical consideration.

Figures

Figure 1
Figure 1
The time course of percent change to baseline in mean arterial pressure. T0 = baseline values; T1 = at 5 min after the patients received midazolam; T2= when BIS was 50 after induction; T3 = at scope intubation; T4-10 = by 5-min intervals during the ERCP.
Figure 2
Figure 2
The time course of percent change to baseline in heart rate. T0 = baseline values; T1 = at 5 min after the patients received midazolam; T2= when BIS was 50 after induction; T3 = at scope intubation; T4-10 = by 5-min intervals during the ERCP.
Figure 3
Figure 3
The SpO2% levels over the designated time points. T0 = baseline values; T1 = at 5 min after the patients received midazolam; T2= when BIS was 50 after induction; T3 = at scope intubation; T4-10 = by 5-min intervals during the ERCP.
Figure 4
Figure 4
Survival analysis. Overall survival was defined as the interval between treatment and death of any cause.

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Source: PubMed

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