The Study Of The Comparison Between The Effect Of Etomidate And Propofol Induction On The Hemodynamics Of Hypertensive Patients

Objective:The study was aimed at observing the effect of etomidate and propofol induction on the hemodynamics of hypertensive patients,such as IBP,HR,SpO₂,and NE.Then based on the observed data,the hemodynamic changes before and after induction of etomidate and propofol,and during tracheal intubation were compared to explore whether etomidate is suitable for anesthesia induction of hypertension patients.Methods:100 samples of ASA II^III patients with 40⁷5 years old undergoing forensic surgery,gynecologist,or urological laparoscopic surgery with essential hypertension were chosen.All patients were without severe cardiopulmonary disease.The liver and kidney function of them was good.They were without endocrine,metabolic,and adrenal diseases.The patients didn't take hormone drugs before preoperative stage.The patients were divided into etomidate group?group Y?and propofol group?group B?according to the random table method.Each group had 50 samples.The general data of the two groups had no statistical significance?P>0.05?.The peripheral vein and central vein were opened after the patient entering the room.The peripheral vein was used for drug delivery,and the central vein was used for blood collection.The direct arterial pressure,electrocardiogram?ECG?,pulse oxygen saturation?pulse oxygen saturation?,and the partial pressure of the end expiratory carbon dioxide were monitored.The dosage of etomidate for anesthesia induction in group Y was0.25⁰.3mg·kg^-1.The dosage of propofol in group B was 2².5mg·kg^-1,and all were injected in 60 s.When the patient's consciousness disappeared,the BIS value was smaller than 60,then the two groups were injected with sufentanil of 0.5⁰.6?g·kg^-1and cisatracurium ammonium of 0.2mg/kg.Mechanical ventilation was operated after endotracheal intubation,maintaining P_ETCO₂ at 35⁴5mmHg at the end of the respiratory tract.The parameters,such as invasive blood pressure?IBP?,heart rate?HR?,oxygen saturation?SpO₂?and serum norepinephrine?NE?,were monitored at the moment before induction?T₀?,intubation?T₁?,l min after intubation?T₂?,5 min after intubation?T₃?and 10 min after intubation?T₄?respectively.Results:?1?In the Group Y,SBP,DBP,HR,and NE increased rapidly at T₁,and compared with the parameters at T₀,there was significant difference?P<0.01?.Meanwhile,There were significant differences in SBP,HR,and NE at T₂?P<0.01?.?2?In the Group B,SBP and DBP decreased at T₁ and T₂,and there was significant difference compared with the parameters at T₀?P<0.01?.?3?The parameters associated with the Group Y at the moment T₁ and T₂ were significantly different from those associated with the Group B?P<0.01?.Conclusion:When etomidate is used to induce anesthesia in patients with essential hypertension patients,it cannot effectively prevent adverse stress reaction caused by endotracheal intubation.However,blood pressure induced by intravenous propofol decreases significantly,which can reduces the adverse reactions caused by endotracheal intubation.It is more suitable for venous induction in patients with essential hypertension.