: Comparing the effect of propofol+ ketamine with propofol+etomidate on hemodynamic stability during induction of anesthesia in elderly patients candidate for elective surgeries.

Abstract

Anesthesia induction with propofol usually accompany with significant decrease in mean blood pressure especially in patients more than 50 years old. Various methods are recommended to prevent hemodynamic instability due to induction with propofol. Current study evaluates hemodynamic effects of ketamine and propofol in comparison to etomidate and propofol during anesthesia induction. Methods: Sixty-two patients over 50 years old undergoing elective general, urology or orthopedic surgery were randomly assigned to ketamine + propofol (n=30) and etomidate + propofol (n=32) groups. Patients in ketamine + propofol group were inducted with ketamine 0.75 mg/kg and propofol 1 mg/kg. In etomidate + propofol group, induction was done with propofol 0.2 mg/kg and propofol 1 mg/kg. Hemodynamic states before and after induction, first, third and sixth minutes after intubation were measured and compared between groups. Results: There was no difference between groups in systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP), heart rate (HR) and blood saturation (SaO2). There was significant decrease in SBP, DBP and MBP after induction and 6 minutes after intubation and in HR after induction than values before induction. In ketamine + propofol group, HR at sixth minute after intubation was lower and first minute after intubation was higher than values before induction. There was significant increase in SaO2 values in all evaluated periods than before induction in etomidate + propofol group, but the difference in ketamine + propofol group was not significant.