Comparison of different induction agents used for rapid sequence intubation

Securing the airway is the first step that clinicians take care of for clinically unstable patients. Rapid sequence intubation (RSI) has been reported by many clinicians to effectively achieve this. Many agents have been reported in the literature as effective induction agents for RSI. In this literature review, we have discussed the efficacies of the different induction agents that are commonly reported in the literature for RSI. Furthermore, RSI is done by paralytic and sedative agents that rapidly render the patient flaccid and unconscious to facilitate the emergent approaches to achieve successful tracheal intubation and minimize adverse events. We have discussed the efficacies and adverse events of benzodiazepines and barbiturates, ketamine, propofol, and etomidate. Each of these modalities has its advantages and adverse events, and clinicians should choose what is best for their patients based on the aforementioned discussion for each drug modality. We recommend that further investigations might be needed for further optimization of the induction agent and the relevant doses.

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.

Comparison of alfaxalone versus propofol as anaesthetic induction agents in increasing the rate of survival and vigour of neonates

PICO question In routine canine caesareans, is alfaxalone a superior anaesthetic induction agent than propofol in increasing the rate of survival and vigour of neonates? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three randomised positive clinical trials have compared the efficacy between alfaxalone and propofol in routine canine caesarean sections for increased neonatal survival and vigour Strength of evidence Weak Outcomes reported Although two studies found alfaxalone to be associated with higher Apgar scores for neonates than propofol, each study nonetheless revealed positive vigour and high survival rates from the use of either alfaxalone or propofol. The evidence is too weak to suggest that one induction agent is superior to another. The selection between the two induction agents may not be the main concern in regard to neonatal depression and 24 hour survival post-delivery, provided that the entire canine caesarean protocol is thoroughly and carefully studied Conclusion Text here How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

Evaluate the efficiency of some biological and chemical factors to control of Pseudomonas syringae pv. Lachrymans parasitizing on cucumber

"The study aimed to investigate to the spread areas of angular spotting disease on cucumber leaves caused by Pseudomonas syringae pv. Lachrymans In the greenhouses of three areas (Al-Qazwiynia , Abbasiya and Al-Haidariya) In the province of Najaf and the first time in Iraq to evaluate the efficiency of using chemical and biological induction agents to control angular spotting disease on cucumber leaves. The geographical distribution of the infected areas and the phenotypic diagnosis of symptoms were confirmed by field survey of the disease. It was later revealed that the diagnosed symptoms were similar to the symptoms of the disease, Where the rate of infection in plastic houses covered by the survey ranged between 19% to 35%. Results of the effect of biochemical and chemical agents on p. syringae pv. Lachrymans showed that treatment of P. putida was increased leaves content of chlorophyll, IAA and GA3 (93.28 mg.100g-1 , 1.61 µM and 24.02 µM, respectively) compared to control 2 treatment (44.65 mg.100g-1 , 0.84µM and 8.68 µM). Results showed that P. fluorescens was decresed ABA hormone which made plant health (324.19 µM) compared to Control 2 treatment (574.53 µM). The treatment of super fifty was superior in leaf content of carbohydrates, protein, CAT, POD, (28.25 mg.g-1 , 17.06%, 186.68 units.min.g-1 , 179.91 units.min.g-1) compared to control 2 treatment (13.19 mg.g-1, 8.56%, 58.16 units.min.g-1 , 105.90 units.min.g1). "

Chemically-Induced Colitis Models in Animal

Ulcerative colitis is a chronic inflammation that can affect the distal part of the colon, submucosa and rectal mucosa, and can affect the entire colon even to the terminal ileum. There are several factors that can cause this disease, such as genetics, environment, intestinal microbiota and the presence of enteric infectious agents. Chemical induction in experimental animals for research on gastrointestinal inflammation has been frequently used due to the similarity of the anatomical and physiological structures of experimental animals with the human digestive tract. This review focuses on recent understanding of the chemicals that used as induction agents in animals

Propofol Is a Better Induction Agent than Etomidate

Induction refers to the start of anesthesia when the patient is rendered unconscious. The intravenous induction agents allow the patient to experience a pleasant loss of consciousness while also rapidly achieving surgical levels of anesthesia. An ideal induction agent must have a rapid onset and offset of action, and must be easy to administer and without significant side effects. Currently, the commonest used agents include sodium pentothal, propofol, ketamine, and etomidate. Unfortunately, none of these agents possess the characteristics of an ideal induction agent. In this article, we will discuss the merits of propofol as an ideal induction agent for cardiac surgery and how it scores over etomidate for the same purpose.