Comparison of the hemodynamic effects of etomidate-midazolam and ketamine-midazolam combinations in anesthesia induction in coronary artery bypass surgery

Authors : Özgür KÖMÜRCÜ, Aynur CAMKIRAN FIRAT, Nilüfer BAYRAKTAR, Atilla SEZGİN, Gülnaz ARSLAN

Pages : 89-94

Doi:10.18663/tjcl.1219943

View : 18 | Download : 13

Publication Date : 2023-03-23

Article Type : Research Paper

Abstract :Aims: We aimed to compare the effects of anesthesia induction on hemodynamic parameters of ketamine-midazolam or etomidate-midazolam combinations and coronary artery bypass grafting surgery. Material and Methods: 40 adult patients undergoing CABG were randomly allocated into two groups for this prospective randomized double-blinded study. Ketamine group insert ignore into journalissuearticles values(n = 20); and Etomidate group insert ignore into journalissuearticles values(n = 20);. Intraoperative and postoperative hemodynamic variables, adrenal gland functions and intensive care period were compared after anesthesia induction with etomidate and ketamine. Results: Perioperative hemodynamic parameters were not significantly different between the groups. Despite similar baseline measurements, cortisol levels were significantly higher 5 minutes after induction, during rewarming, and after ACTH stimulation test at postoperative day 1 in group ketamine than group etmidate. The groups were not significantly different in terms of duration of postoperative mechanical ventilation, frequency of postoperative delirium, and intensive care unit and hospital lengths of stay. Conclusion: Ketamine-midazolam combination is an acceptable alternative to etomidate-midazolam combination in terms of hemodynamic stability. Compared with the ketamine-midazolam combination, the etomidate-midazolam combination significantly decreased cortisol levels during the intraoperative and early postoperative periods
Keywords : Koroner arter bypas greftleme, hemodinamik instabilite, adrenal süpresyon, etomidat, ketamin