Comparative Study of Hemodynamic Response to Etomidate Versus Ketofol Anesthetic Induction in Patients with Reduced Ejection Fraction Undergoing Coronary artery bypass grafting (CABG)

Abstract

Background: Coronary artery bypass grafting surgery is the commonest surgery done in patients with various cardiovascular diseases. Doing the CABG surgery in patients with reduced ejection fraction is associated with mortality. Anesthesia used in the CABG surgery in patients with reduced ejection fraction plays major role in surgical outcome. The present study aimed to evaluate the hemodynamic response to etomidate versus ketofol anesthetic induction in patients with reduced ejection fraction undergoing CABG surgery. Materials and Methods: This study was conducted in a total of 70 patients selected in the based on the inclusion and exclusion criteria. Patients were divided in to two groups, group-I received Etomidate and group-II Ketofol respectively. For all the patients demographic data , systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate were recorded at different time periods (at baseline, after 1 min of induction , before laryngoscopy (BL) , after laryngoscopy(AL) , 2min following lscopy )and the data was enter in excel sheet used for analysis. Statistical Package for Social Sciences (SPSS 20.0) version used for analysis. Results: Maximum number of patients had age between 51-60 years in both groups. Comparison of mean between the groups not showed any significant difference. Group-I and II had similar gender distribution. Mean weight between the group-I and II not showed any significant difference. Comparison of mean systolic blood pressure at baseline, After Laryngoscopy (AL) and 2 min following laryngoscopy not showed significant difference, but at 1 min and Before Laryngoscopy (BL) values showed significant difference. Baseline, 1 min, BL and AL diastolic blood pressure showed significant difference compared between group-I and II not at 2 min. Mean arterial pressure showed significant difference compared between group-I and II at 1 min and BL and no other time periods. Comparison of heart rate between the groups at baseline and 1 min showed significant difference with p value 0.05. Conclusion: These study observations concluded that patients received etomidate showed better hemodynamic stability at all the time periods compared to ketofol in patients undergoing CABG surgery with reduction ejection fraction.

Keywords:  Ketofol, Etomidate, CABG surgery, reduction ejection fraction, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure.