The findings of our study showed that the changes in hemodynamic parameters, including blood pressure, heart rate and SPO2, were similar in the two groups receiving E and TM combination, but 10 minutes after intubation, the TM group had lower mean DBP and MAP.
Also, there were significant changes in blood pressure and heart rate during the study period in both groups. The trend of changes in SPO2 was significant in E group and not significant in TM group. On the other hand, the frequency of hypertension was higher in etomidate group, but no significant difference observed between the two groups.
The findings of our study showed that the changes in hemodynamic parameters, including blood pressure, heart rate and SPO2, were similar in the two groups receiving E and TM combination, but 10 minutes after intubation, the TM group had lower mean diastolic pressure and mean arterial pressure.
The frequency of adverse response to laryngoscopy and tracheal intubation, including tachycardia, increased blood pressure, and irregular heart rate, was not different between the two groups. In this regard, the results of Masoudi Far et al.'s study comparing the effects of induction of anesthesia with three drugs, etomidate, propofol, and sodium thiopental, on hemodynamic status in laryngoscopy suspension surgery, did not report significant differences between the three groups in terms of hemodynamic changes .18 In the study of Hasni et al., investigated the effect of etomidate and sodium thiopental during induction of general anesthesia and tracheal intubation on the changes of BIS (bispectral index scale) and hemodynamic parameters in two groups. In the results, the BIS values recorded in the thiopental group were significantly higher than the etomidate, but the hemodynamic changes in the two groups were not significantly different. 19
In the present study, there was no significant difference between the two study groups in terms of cardiovascular response to tracheal intubation, which is similar to the above studies.
In another study conducted by Bass et al., the effect of sodium thiopental, etomidate, propofol and midazolam on the hemodynamic status in cardiac surgery was investigated, in which the study of patients receiving midazolam had higher hemodynamic stability and midazolam was introduced as a safer drug. 20
Sonday et al investigated thiopental versus etomidate for rapid sequence intubation; as a result, they found no clinical difference between the use of etomidate or thiopental with succinylcholine for rapid sequence intubation. 21
In the study of Habibi et al., on 100 patients who were candidates for elective CABG surgery, either etomidate or ketamine-thiopental sodium was used to induce anesthesia, Observed after induction of anesthesia with the administration of ketamine-thiopental sodium, hemodynamic stability was better than sodium thiopental.22
In another study on 120 adult patients aged 18 to 45 who were candidates for elective surgery, they used etomidate (0.3 mg/kg) in the first group, propofol (1.5 mg/kg) and ketamine in the second group, and thiopental (3 mg/kg) ) and ketamine (0.5 mg/kg) in the third group. They found that the propofol-ketamine combination can act as an effective and safe induction agent to reduce hemodynamic responses to laryngoscopy and intubation along with hemodynamic stability.23
According to the findings of the present study, the duration of laryngoscopy in the group receiving etomidate was significantly less than that of TM, on the other hand, the complications during laryngoscopy were not significantly different between the two groups, which is consistent with the findings of Masoudi Far et al.'s study.18
At the same time, according to the findings of the present study, it seems that the cardiovascular response to the combination of TM is similar to etomidate, although due to the limitations of this study, including the small sample size, more studies with the above drugs are necessary.