title: Hemodynamic responses to etomidate versus ketamine-thiopental sodium combination for anesthetic induction in coronary artery bypass graft surgery patients with low ejection fraction: a double-blind, randomized, clinical trial.
abstract: BACKGROUND
  During induction of anesthesia and intubation, hemodynamic changes are very important; especially in patients with coronary artery disease (CAD) and left ventricular dysfunction. A little information is available on the hemodynamic effects of a combination of ketamine-thiopental for induction of anesthesia in patients undergoing coronary artery bypass graft (CABG) surgery, with impaired ventricular function.
  
  
  OBJECTIVE
  The aim of this study was to compare the hemodynamic responses to etomidate versus ketamine-thiopental sodium combination for anesthetic induction in CABG surgery patients with low ejection fraction (EF<45%).
  
  
  METHODS
  In a double blind randomized clinical trial, a total of 100 patients, scheduled for elective CABG surgery were randomly assigned into two groups. These patients received either etomidate or ketamine-thiopental sodium combination at induction of anesthesia. Hemodynamics variable were measured and recorded at baseline, immediately before and after laryngoscopy and intubation, one, two and three minutes after intubation. Also, muscle twitching incidence among patients in two groups was evaluated.
  
  
  RESULTS
  No significant differences between the two groups regarding the changes of hemodynamic variables including systolic and diastolic arterial blood pressure, mean arterial pressure and heart rate, were notice (p>0.05). Muscle twitching was not observed in the two groups.
  
  
  CONCLUSIONS
  Hemodynamic stability after administration of ketamine-thiopental sodium combination for induction of anesthesia in patients undergoing CABG surgery, with impaired ventricular function, supports the clinical impression that this combination is safe in CABG surgery patients with low EF.
authors.affiliation: Faculty of Medicine, Department of Anesthesiology, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Habibi
authors.affiliation: Faculty of Medicine, Department of Anesthesiology, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Afshin Gholipour
authors.initials: AG
authors.lastname: Baradari
authors.affiliation: Faculty of Paramedicine, Department of Anesthesiology, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Aria
authors.initials: A
authors.lastname: Soleimani
authors.affiliation: PhD Student in Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences , Mashhad, Iran .
authors.forename: Amir
authors.initials: A
authors.lastname: Emami Zeydi
authors.affiliation: Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Hamid Sharif
authors.initials: HS
authors.lastname: Nia
authors.affiliation: Medical Student, Faculty of Medicine, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Ali
authors.initials: A
authors.lastname: Habibi
authors.affiliation: Medical Student, Faculty of Medicine, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Naser
authors.initials: N
authors.lastname: Onagh
keywords: Anesthesia; CABG; Etomidate; Hemodynamic; Thiopental sodium