title: The Comparison of Etomidate and Propofol Anesthesia in Patients Undergoing Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Etomidate and propofol played an important role in the sedation of patients undergoing gastrointestinal endoscopy. We conducted a systematic review and meta-analysis to compare their efficacy and safety.
  
  
  METHODS
  PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials assessing the effect of etomidate versus propofol for the anesthesia of patients undergoing gastrointestinal endoscopy were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were anesthesia duration and recovery time. Meta-analysis was performed using random-effect model.
  
  
  RESULTS
  Six randomized controlled trials involving 1115 patients were included in the meta-analysis. Overall, compared with propofol, etomidate resulted in comparable anesthesia duration [standard mean difference (Std. MD)=-0.03; 95% confidence interval (CI), -0.16 to 0.10; P=0.66], recovery time (Std. MD=0.25; 95% CI, -0.42 to 0.92; P=0.47), mean arterial pressure at intubation (Std. MD=0.44; 95% CI, -0.26 to 1.15; P=0.21), heart pulse at intubation (Std. MD=0.93; 95% CI, -0.69 to 2.55; P=0.26), SPO2 at intubation (Std. MD=-0.52; 95% CI, -1.04 to 0.01; P=0.05), patient satisfaction [odds risk (OR)=0.42; 95% CI, 0.11-1.66; P=0.22], hypotension (OR=0.14; 95% CI, 0.02-1.22; P=0.07), changes of heart rate (OR=0.97; 95% CI, 0.61-1.53; P=0.88), nausea-vomiting (OR=2.02; 95% CI, 0.73-5.57; P=0.17), and the reduction in apnea or hyoxemia (OR=0.39; 95% CI, 0.24-0.64; P=0.0002), and injection pain (OR=0.03; 95% CI, 0.01-0.08; P<0.00001), but the increase in myoclonus (OR=8.54; 95% CI, 3.14-23.20; P<0.0001).
  
  
  CONCLUSIONS
  Between etomidate and propofol, no significant difference was revealed regarding anesthesia duration, recovery time, mean arterial pressure at intubation, heart pulse at intubation, SPO2 at intubation, patient satisfaction, hypotension, changes of heart rate and nausea-vomiting. Compared with propofol, etomidate showed reduced apnea or hyoxemia, and injection pain, but with an increased myoclonus.
authors.affiliation: Gastrointestinal Department of Internal Medicine, Guizhou Provincial People's Hospital, Guiyang, China.
authors.forename: Limin
authors.initials: L
authors.lastname: Ye
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Xiao
authors.forename: Liyi
authors.initials: L
authors.lastname: Zhu
mesh_terms: D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous; D001049:Apnea / Q000139:chemically induced; D062186:Arterial Pressure / Q000187:drug effects; D003113:Colonoscopy / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005045:Etomidate; D005773:Gastroscopy / Q000379:methods; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D000860:Hypoxia / Q000139:chemically induced; D009207:Myoclonus / Q000139:chemically induced; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D015742:Propofol; D016032:Randomized Controlled Trials as Topic
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol; D005045:Etomidate