title: Comparison of hemodynamic effects of intravenous etomidate versus propofol during induction and intubation using entropy guided hypnosis levels.
abstract: OBJECTIVE
  This study aimed to compare the hemodynamic responses during induction and intubation between propofol and etomidate using entropy guided hypnosis.
  
  
  METHODS
  Sixty ASA I & II patients in the age group 20-60 yrs, scheduled for modified radical mastectomy were randomly allocated in two groups based on induction agent Etomidate or Propofol. Both groups received intravenous midazolam 0.03 mg kg(-1) and fentanyl 2 μg kg(-1) as premedication. After induction with the desired agent titrated to entropy 40, vecuronium 0.1 mg kg(-1) was administered for neuromuscular blockade. Heart rate, systolic, diastolic and mean arterial pressures, response entropy [RE] and state entropy [SE] were recorded at baseline, induction and upto three minutes post intubation. Data was subject to statistical analysis SPSS (version 12.0) the paired and the unpaired Student's T-tests for equality of means.
  
  
  RESULTS
  Etomidate provided hemodynamic stability without the requirement of any rescue drug in 96.6% patients whereas rescue drug ephedrine was required in 36.6% patients in propofol group. Reduced induction doses 0.15mg kg(-1) for etomidate and 0.98 mg kg(-1) for propofol, sufficed to give an adequate anaesthetic depth based on entropy.
  
  
  CONCLUSIONS
  Etomidate provides more hemodynamic stability than propofol during induction and intubation. Reduced induction doses of etomidate and propofol titrated to entropy translated into increased hemodynamic stability for both drugs and sufficed to give an adequate anaesthetic depth.
authors.affiliation: Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: Shagun Bhatia
authors.initials: SB
authors.lastname: Shah
authors.affiliation: Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: Itee
authors.initials: I
authors.lastname: Chowdhury
authors.affiliation: Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: Ajay Kumar
authors.initials: AK
authors.lastname: Bhargava
authors.affiliation: Department of Anaesthesia, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: Bhawnish
authors.initials: B
authors.lastname: Sabbharwal
keywords: Entropy; etomidate; hemodynamic changes; propofol