| Abstract |
Background :To compare the effects of etomidate and midazolam induction on hemodynamic changes during laryngoscopy and intubation in patients undergoing elective Coronary Artery Bypass Graft (CABG) surgery. Method and Material : A total of 70 patients with triple vessel coronary artery disease, aged between 30 to 60 years undergoing CABG surgery were included in this prospective, comparative and randomized study and divided into two groups; group E (Etomidate group, n=35, 0.3mg/kg) and group M (Midazolam group, n=35, 0.15mg/kg). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), central venous pressure (CVP), cardiac output (CO), cardiac index (CI) and systemic vascular resistance index (SVRI) were recorded at various time points starting from preinduction till 10 minutes after intubation. Statistical Analysis: The SPSS, version 20 for Windows statistical software package (SPSS inc., Chicago, Illinois, USA). Results were analyzed using student’s t-test and paired t-test. Results: In group M after induction HR increased (P <0.05); SBP and MAP decreased (P <0.05), while at 1 min after tracheal intubation the values of HR increased and SBP decreased (p <0.05). Whereas in group E, HR and SBP increased remarkably at 1 min after intubation (P < 0.001 and P <0.05, respectively). Both the groups showed no significant change in DBP, CO and CI before and after intubation. There was significant decrease in CVP in both the groups (P <0.001). Group M showed significant decrease in SVRI (P <0.001). Conclusion :In comparison with Etomidate, Midazolam used for the induction of anesthesia in CABG surgery was more effective in preventing the adverse cardiovascular response to laryngoscopy and intubation.
KEYWORDS: Anesthesia induction, Coronary artery bypass graft surgery, Triple vessel coronary artery disease. |
