Effects of propofol versus etomidate on laryngoscopic tracheal intubation conditions and stress response in elderly patients taking general anesthesia
Objective To explore the effects of propofol versus etomidate on laryngoscopic tracheal intubation conditions and stress response in elderly patients taking general anesthesia.Methods One hundred and thirty elderly patients who underwent elective orthopedic surgery under general anesthesia at Hospital Affiliated to Shaanxi University of Chinese Medicine from June 2022 to August 2023 were selected for the randomized controlled trial.They were divided into a propofol group(group P)and an etomidate group(group E)by the random number table method,with 65 cases in each group.Group P took anesthesia induction by 2.0 mg/kg propofol,and group E by 0.3 mg/kg etomidate;both groups combined with 0.50 pg/kg sufentanil and 0.15 mg/kg cisatracurium.The intubation conditions were evaluated by the Viby-Mogensen Intubation Conditions Scale immediately after intubation.The meal artery pressure(MAP),heart rate(HR),and rate pressure product(RPP)were recorded before anesthesia induction(T0),immediately after propofol/etomidate injection(T1),after laryngoscope insertion(T2),1 min after tracheal intubation(T3),and 3 min after successful tracheal intubation(T4).The levels of norepinephrine(NE),cortisol(Cor),and blood glucose were compared at T0,T2,and T4.The incidences and severities of injection pain within 30 s after propofol or etomidate injection were compared between the two groups.The tracheal intubation times were compared between the two groups.The x2 test,Mann-Whitney U test,tepeated measurement ANOVA,and t test were used.Results There were no statistical differences in the basal line data,such as age,gender,body mass index,American Society of Anesthesiology(ASA)grading,etc.,between the two groups(all P＞0.05).There were no statistical differences in the laryngoscope insertion,vocal cord position,vocal cord movement,airway response,and limb response of the Viby-Mogensen Intubation Conditions Scale between the two groups(all P＞0.05).The MAP's at T2,T3,and T4 in group E were higher than those in group P;the HR's at T2,T3,and T4 in group E were lower than those in group P;there were statistical differences(all P＜0.05).The levels of NE[(135.32±30.47)pg/L vs.(147.54±32.16)pg/L],Cor[(68.39±14.12)ng/L vs.(76.17± 14.65)ng/L],and blood glucose[(5.46±0.64)mmol/L vs.(6.04±0.76)mmol/L]atT2 in group E were lower than in group P,with statistical differences(all P＜0.05).The levels of NE[(154.69±33.42)pg/L vs.(170.35±36.30)pg/L],Cor[(73.42±14.59)ng/L vs.(82.64±16.73)ng/L],and blood glucose[(6.72±0.95)mmol/L vs.(8.29±1.03)mmol/L]T3 in group E were lower than those in group P,with statistical differences(all P＜0.05).There was no statistical difference in tracheal intubation time between the two groups(P＞0.05).The incidence of injection pain and injection pain score in group E were lower than those in group P[17.46％(11/63)vs.56.67％(34/60)and 0(0,1)vs.1(0,1)],with statistical differences(both P＜0.05).Conclusions Application of 2.0 mg/kg propofol and 0.3 mg/kg etomidate combined with 0.50 μg/kg sufentanil and 0.15 mg/kg cisatracurium in laryngoscopic tracheal intubation of elderly patients taking general anesthesia both have comparable conditions for tracheal intubation,but the induction by etomidate has more stable hemodynamics,milder stress response,and less severe injection pain.
PropofolEtomidateSurgery for elderly patients under general anesthesiaLaryngoscopyTracheal intubationStress response
万方数据
维普
