Etomidate and Propofol: Which Would be Safe from the Hemodynamic Viewpoint in Colonoscopy Exams?
Main Article Content
Abstract
Justification
Most patients who undergo colonoscopy are over 55 years old, with comorbidities and who use cardio-depressant drugs. In addition, exam preparation includes the use of osmotic diuretics, causing osmotic diarrhea leading many patients to some degree of dehydration. Considering all these factors and knowing that the drug selected for sedation also acts by depressing the cardiovascular system, this study proposes to evaluate the action of two hypnotic drugs (etomidate and propofol) routinely used for sedation..
Methods
In two private clinics, 105 participants (18 to 90 years old), ASA I and ASA II (American Society of Anaesthesiologist score) were selected. Participants were divided into two groups: fentanyl 1 mcg / kg + midazolam 0.03 mg / kg + etomidate 0.3 mg / kg (n = 52) and fentanyl 1 mcg / kg + midazolam 0.03 mg / kg + propofol 2 mg / kg (n = 53). Participants were monitored with cardioscope, pulse oximeter and tensiometer. Blood pressure, heart rate and oxygen saturation parameters were observed before, during and after the exam.
Results
Most participants were ASA II (63%) and female (74%). In subjects who received propofol group significant reductions in the systolic (p <0.05) and diastolic (p <0.05) blood pressures and significantly increased heart rate (p <0.05) compared to the group receiving etomidate. There was no difference in hemodynamic variation between male and female participants. There was no difference in satisfaction of endoscopists and patients regarding medications used for sedation.
Conclusion
The hypnotic drug etomidate was safer from the hemodynamic point of view for sedation in colonoscopy exams.
Article Details
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