Cardioversion: What to choose Etomidate or propofol.

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dc.contributor.authorDesai, Pushkar M
dc.contributor.authorKane, Deepa
dc.contributor.authorSarkar, Manjula S
dc.date.accessioned2015-08-22T08:04:43Z
dc.date.available2015-08-22T08:04:43Z
dc.date.issued2015-07
dc.description.abstractContext: Electrical cardioversion is a short painful procedure to regain normal sinus rhythm requiring anaesthesia for haemodynamic stability, sedation, analgesia and early recovery. Aims: To compare propofol and etomidate as sedatives during cardioversion. Settings and Design: Single centred, prospective and randomized single blind study comprising 60 patients. Subjects and Methods: Patients more than 18 years, American Society of Anesthesiologists I/II/III grades undergoing elective cardioversion, randomly divided to receive propofol 1 mg/kg intravenous (IV) bolus followed by 0.5 mg/kg (Group P, n = 30) or etomidate (Group E, n = 30) 0.1 mg/kg followed by 0.05 mg/kg. All patients received IV fentanyl (1 μg/kg) before procedure. Heart rate, blood pressure (BP) (systolic BP [SBP], diastolic BP [DBP], mean arterial pressure), respiratory rate, Aldrete recovery score (ARS) and Ramsay sedation score (RSS) were assessed at 1, 2, 5, 10, 15, 20 and 30 min post cardioversion. Incidence of hypotension, respiratory depression and side effects were compared. Statistical analysis used: Student’s unpaired t‑test, Chi‑square test and Mann–Whitney test. P < 0.05 was taken as significant. Results: Group P showed significant fall in SBP, DBP, and mean BP at 2 min after cardioversion. Hypotension (33.3% Group P vs. 16.65% Group E) occurred more with propofol (P < 0.05). Group E showed better ARS at 1, 2, 5, 10, 15 and 20 min. Time required to attain RSS = 2 (659.1 s Group P and 435.7 s Group E) indicated longer recovery with propofol. Left atrial size (35.5-42.5 mm) did not affect success rate of cardioversion (80% Group P vs. 83.3% Group E). Incidence of myoclonus (Group E 26.67% vs. Group P 0%) showed significant difference. Conclusions: Etomidate/fentanyl is superior over propofol/fentanyl during cardioversion for quick recovery and haemodynamic stability.en_US
dc.identifier.citationDesai Pushkar M, Kane Deepa, Sarkar Manjula S. Cardioversion: What to choose Etomidate or propofol. Annals of Cardiac Anaesthesia. 2015 Jul; 18(3): 306-311.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/162328
dc.language.isoenen_US
dc.source.urihttps://www.annals.in/article.asp?issn=0971-9784;year=2015;volume=18;issue=3;spage=306;epage=311;aulast=Desaien_US
dc.subjectCardioversionen_US
dc.subjectEtomidateen_US
dc.subjectPropofolen_US
dc.subject.meshAdult
dc.subject.meshAtrial Fibrillation --therapy
dc.subject.meshElectric Countershock --methods
dc.subject.meshEtomidate --administration & dosage
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshHypnotics and Sedatives --administration & dosage
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPropofol --administration & dosage
dc.titleCardioversion: What to choose Etomidate or propofol.en_US
dc.typeArticleen_US
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