Comparison of the combination of propofol and etomidate versus propofol or etomidate alone for induction of general anesthesia: a double-blind, randomized controlled trial

IntroductionHemodynamic fluctuation during the induction of general anesthesia is a common event and adversely affect patients’ outcomes. The aim of this study is to investigate the impacts of different anesthesia induction agents: propofol, etomidate, and propofol-etomidate combination on patient hemodynamics and processed electroencephalography (EEG).Material and methodsSeventy-five patients undergoing elective non-cardiac surgery were randomly assigned to three groups of anesthesia induction agents: the group P received 2 mg/kg propofol, the group E received 0.3 mg/kg etomidate, and the group PE received the combination of 1mg/kg propofol plus 0.15mg/kg etomidate. Hemodynamic variables and processed EEG were measured during induction.ResultsHeart rate (HR) was significantly increased at intubation and 1 min after intubation compared with baseline in all three groups. Mean arterial pressure (MAP) decreased significantly after induction, at 5, and 10 min after intubation in group P (79.1±12.6, 77.0±14.2, 76.6±11.4 versus 93.2±9.9 mmHg; all P＜0.001). MAP increased significantly at intubation and 1 min after intubation in group E (104.7±13.0, 103.8±12.8 versus 92.9±10.2; P＜0.001, P=0.001 respectively). The incidence of myoclonus was lower in groups PE (4.0%) and P (4.0%) compared with that in group E (24.0%) (P=0.033). The incidence of pain at injection was higher in group P (28.0%) than that in groups PE and E (4.0% and 0.0%) (P=0.025).ConclusionsThe combination of propofol and etomidate used during induction of anesthesia provided a more stable BP profile, less pain at site of injection, and decreased myoclonic movements compared with propofol or etomidate alone.

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Effect of intravenous dezocine on fentanyl-induced cough during general anesthesia induction: a double-blinded, prospective, randomized, controlled trial

Journal of Anesthesia ◽

10.1007/s00540-011-1237-x ◽

2011 ◽

Vol 25 (6) ◽

pp. 860-863 ◽

Cited By ~ 19

Author(s):

Zhen-Tao Sun ◽

Chun-Yao Yang ◽

Zhi Cui ◽

Jie Zhang ◽

Xue-Ping Han

Keyword(s):

Randomized Controlled Trial ◽

General Anesthesia ◽

Controlled Trial ◽

Anesthesia Induction ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial ◽

Double Blinded

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Comparison of a small dose of oxycodone and sufentanil for the prevention of sufentanil-induced cough during general anesthesia induction: a prospective randomized controlled trial

10.21203/rs.3.rs-355169/v1 ◽

2021 ◽

Author(s):

Lingli Shi ◽

Yong He ◽

Huanhuan Ni

Keyword(s):

Randomized Controlled Trial ◽

General Anesthesia ◽

Small Dose ◽

Elective Surgery ◽

Controlled Trial ◽

Anesthesia Induction ◽

Clinical Trial Registry ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial ◽

Hemodynamic State

Abstract Background: Sufentanil is widely used during anesthesia induction. However, sufentanil injections can cause cough through different mechanisms. This study aimed to evaluate the effectiveness of a small dose of oxycodone and sufentanil in suppressing sufentanil-induced cough (SIC) during general anesthesia induction.Methods: This prospective, randomized, controlled trial was conducted form February 12, 2019 to December 30, 2019. A total of 174 patients were scheduled for elective surgery, and 144 screened patients were randomly divided into 3 groups (n=48). Five minutes before sufentanil bolus (0.4 μg/kg), patients in group O received 0.02 mg/kg oxycodone intravenously within 5 s, those in group S received 0.02 μg/kg sufentanil within 5 s and those in group N received an equal volume of 0.9% normal saline within 5 s. Sufentanil was diluted to 5 μg/ml and administered within 5 s after pretreatment. The incidence and severity of cough in the three groups were evaluated within 1 minute after sufentanil injection during anesthesia induction. Mean arterial pressure (MAP) and heart rate (HR) were recorded at T0 (after entering the operation), T1 (3 minutes after pretreatment), T2 (before intubation), and T3 (1 minute after intubation).Results: The incidences of cough in group N, group O, and group S were 20 (41.6%), 7 (14.5%), and 6 (12.5%), respectively. Compared with group N, group O and group S exhibited significantly reduced incidence and severity of cough, and the severity of cough in group O and group S was dramatically reduced compared with that in group N (P<0.05). No significant differences in the rangeability of MAP and HR were noted at the four time points in the three groups (P> 0.05).Conclusion: Intravenous oxycodone (0.02 mg/kg) and sufentanil (0.02 μg/kg) represent effective approaches to reducing SIC in anesthesia induction and ensuring a relatively stable hemodynamic state during general anesthesia induction.Trial registration: Chinese Clinical Trial Registry (ChiCTR1900021087, registered date: January 28, 2019), http://www.chictr.org.cn

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Hydroxyethyl starch 130/0.4 versus crystalloid co-loading during general anesthesia induction: a randomized controlled trial

Journal of Anesthesia ◽

10.1007/s00540-017-2416-1 ◽

2017 ◽

Vol 31 (6) ◽

pp. 878-884 ◽

Cited By ~ 2

Author(s):

Takashi Juri ◽

Koichi Suehiro ◽

Shigemune Kuwata ◽

Sayaka Tsujimoto ◽

Akira Mukai ◽

...

Keyword(s):

Randomized Controlled Trial ◽

General Anesthesia ◽

Hydroxyethyl Starch ◽

Controlled Trial ◽

Anesthesia Induction ◽

Randomized Controlled

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N-acetylcysteine Restored Heart Rate Variability and Prevented Serious Adverse Events in Transfusion-dependent Thalassemia Patients: a Double-blind Single Center Randomized Controlled Trial

International Journal of Medical Sciences ◽

10.7150/ijms.45795 ◽

2020 ◽

Vol 17 (9) ◽

pp. 1147-1155

Author(s):

Sintip Pattanakuhar ◽

Arintaya Phrommintikul ◽

Adisak Tantiworawit ◽

Somdet Srichairattanakool ◽

Siriporn C. Chattipakorn ◽

...

Keyword(s):

Heart Rate ◽

Randomized Controlled Trial ◽

Heart Rate Variability ◽

Adverse Events ◽

Controlled Trial ◽

Single Center ◽

Serious Adverse Events ◽

Double Blind ◽

Randomized Controlled

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Ketorolac tromethamine pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a prospective randomized controlled trial

BMC Anesthesiology ◽

10.1186/s12871-020-01124-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Zhen Tian ◽

Bei Hu ◽

Min Miao ◽

Lulu Zhang ◽

Lin Wang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

General Anesthesia ◽

Controlled Trial ◽

Anesthesia Induction ◽

Ketorolac Tromethamine ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial

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Transcutaneous electrical acupoint stimulation before induction of anesthesia reduces sufentanil-induced cough: a randomized, controlled trial

10.22514/sv.2021.024 ◽

2021 ◽

Keyword(s):

Heart Rate ◽

Randomized Controlled Trial ◽

General Anesthesia ◽

Controlled Trial ◽

Inhibitory Effect ◽

Common Side Effect ◽

Control Group ◽

Randomized Controlled ◽

The Mean ◽

Acupoint Stimulation

Background: Sufentanil-induced cough is a common side effect during the induction of general anesthesia. This study sought to determine the inhibitory effect of TEAS (transcutaneous electrical acupoint stimulation) on the incidence of sufentanil-induced cough. Methods: A total of 339 patients were recruited of which 300 patients were enrolled and randomly allocated into five groups (n = 60): Patients did not receive TEAS in the control group (C group); patients received 2 Hz TEAS at LI4/PC6 (Hegu/Neiguan) in the 2A group; patients received 100 Hz TEAS at LI4/PC6 in the 100A group; patients received 2 Hz TEAS at ST36/SP6 (Zusanli/sanyinjiao) in the 2B group; and patients received 100 Hz TEAS at ST36/SP6 in the 100B group. With the exception of the C group, all groups received TEAS for 30 minutes before induction. 0.5 µg/kg of IV sufentanil was given over 2 seconds, and the occurrence of cough was observed and recorded for 1 minute. The severity of cough was graded as mild (1-2 coughs), moderate (3-5 coughs), and severe (> 5 coughs). The mean arterial pressure (MAP) and heart rate (HR) before (T0) and 1 minute after (T1) sufentanil injection were recorded. Results: The incidence of sufentanil-induced cough in C group, 2A group, 2B group, 100A group and 100B group were 37%, 27%, 27%, 12% and 13%, respectively. Compared with the C group, the incidence of cough in the 100A group and the 100B group were significantly lower (P < 0.05). The MAP and HR between the five groups were not statistically different. Conclusion: The administration of 100 Hz TEAS for 30 minutes before sufentanil injection can effectively reduce the incidence of sufentanil-induced cough during the induction of general anesthesia.

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