The effects of propofol-midazolam-ketamine co-induction on hemodynamic changes and catecholamine response

被引:12
|
作者
Abbasivash, Rahman [1 ]
Aghdashi, Mir Moosa [1 ]
Sinaei, Behzad [1 ]
Kheradmand, Fatemeh [2 ]
机构
[1] Urmia Univ Med Sci, Imam Khomeini Hosp, Dept Anesthesiol, Orumiyeh, Iran
[2] Urmia Univ Med Sci, Fac Med, Dept Biochem, Ctr Cellular & Mol Res, Orumiyeh, Iran
关键词
Etomidate hemodynamics; Ketamine hemodynamics; Midazolam; Propofol; EMERGENCY-DEPARTMENT; PROCEDURAL SEDATION; KETOFOL; INTUBATION; PARAMETERS; ANESTHESIA; ANALGESIA; INSERTION; TRIAL;
D O I
10.1016/j.jclinane.2014.05.014
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Study Objective: To compare the clinical efficacy of co-induction with propofol-midazolam-ketamine with etomidate as the sole induction agent. Design: Prospective, double-blinded, randomized controlled trial. Setting: Operating room of a university hospital. Patients: 60 ASA physical status 1 and 2 patients scheduled for limited elective surgery requiring general anesthesia. Interventions: Patients were randomized to two groups to receive etomidate 0.3 mg/kg (single-drug group) or propofol 0.6 mg/kg + ketamine 0.8 mg/kg + midazolam 0.06 mg/kg (three-drug group). Measurements: Hemodynamic responses (systolic and diastolic blood pressure, and mean arterial pressure) were examined at baseline and at one, three, and 5 minutes after tracheal intubation. Plasma catecholamine levels were measured at baseline, one, and 5 minutes after tracheal intubation. Main Results: Heart rate (HR) changes differed significantly between the two groups at three minutes (P = 0.01) and 5 minutes (P = 0.00) after tracheal intubation. However, the HR increase in the three-drug group was in the acceptable range. Percentage changes of epinephrine level differed between the two groups at 5 minutes after tracheal intubation (P = 0.03). Conclusions: The higher norepinephrine/epinephrine ratio noted in the single-drug group may be implicated in lower adrenal sympathetic activity. Propofol-midazolam-ketamine co-induction may be used instead of etomidate for anesthesia induction in patients with hemodynamic instability. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:628 / 633
页数:6
相关论文
共 50 条
  • [41] Hemodynamic and catecholamine responses in patients during rapid sequence induction with propofol
    Hara, T
    Fukusaki, M
    Nakamura, T
    Niiya, S
    Sumikawa, K
    ANESTHESIA AND ANALGESIA, 1998, 86 (2S):
  • [42] A COMPARISON OF HEMODYNAMIC EFFECTS OF ETOMIDATE-MIDAZOLAM AND KETAMINE-MIDAZOLAM FOR ANESTHESIA INDUCTION IN CORONARY ARTERY BYPASS GRAFTING SURGERY
    Pirat, A.
    Komurcu, O.
    Camkiran, A.
    Arslan, G.
    Bayraktar, N.
    Sezgin, A.
    INTENSIVE CARE MEDICINE, 2013, 39 : S414 - S414
  • [43] Co-induction of anaesthesia with alfaxalone and midazolam in dogs: a randomized, blinded clinical trial
    Miller, Chris
    Hughes, Ellen
    Gurney, Matt
    VETERINARY ANAESTHESIA AND ANALGESIA, 2019, 46 (05) : 613 - 619
  • [44] Sympathetic and hemodynamic effects of conscious sedation with midazolam and propofol in humans
    Ebert, TJ
    Trotier, T
    Guttersen, RV
    Uhrich, TD
    ANESTHESIOLOGY, 1999, 91 (3A) : U123 - U123
  • [45] Hemodynamic Effects of Ketamine Infusion in the Intensive Care Unit for Maintenance Sedation Compared With Propofol and Midazolam: A Retrospective Cohort Study
    Khatib, Sohaib
    Roelofsz, David
    Singh, Som
    Rao, Arjun
    Brinton, Taylor
    Howell, Gregory
    OCHSNER JOURNAL, 2022, 22 (03): : 225 - 229
  • [46] Hemodynamic and catecholamine responses during rapid sequence induction with propofol in hypertensive patients
    Nakamura, T
    Fukusaki, M
    Sakamoto, A
    Miyako, M
    Niiya, S
    Sumikawa, K
    ANESTHESIA AND ANALGESIA, 1999, 88 (02):
  • [47] The effects of etomidate and propofol induction on hemodynamic and endocrine response undergoing CABG surgery
    Hosten, Tuelay
    Solak, Mine
    Kilickan, Levent
    Ozdamar, Dilek
    Toker, Kamil
    TRAKYA UNIVERSITESI TIP FAKULTESI DERGISI, 2007, 24 (02): : 114 - 126
  • [48] Effects of propofol with and without ketamine on the cerebral circulation and CO2 response
    Sakai, K
    Cho, S
    Shibata, O
    Sumikawa, K
    ANESTHESIOLOGY, 1998, 89 (3A) : U316 - U316
  • [49] Hemodynamic Changes following Anesthesia Induction and LMA Insertion with Propofol, Etomidate, and Propofol
    Hosseinzadeh, Hamzeh
    Golzari, Samad E. J.
    Torabi, Effat
    Dehdilani, Marjan
    JOURNAL OF CARDIOVASCULAR AND THORACIC RESEARCH, 2013, 5 (03) : 109 - 112
  • [50] Cardiopulmonary effects of propofol and a medetomidine-midazolam-ketamine combination in mallard ducks
    Machin, KL
    Caulkett, NA
    AMERICAN JOURNAL OF VETERINARY RESEARCH, 1998, 59 (05) : 598 - 602