Comparison of etomidate and propofol for sedation in outpatient urologic surgeries, a randomized clinical trial

摘要

Introduction: Propofol and etomidate are popular hypnotic agents in outpatient settings. We studied sedative, hemodynamic, and adverse effects of these two drugs in patients undergoing outpatient urologic surgeries. Methods: In this randomized clinical trial, 177 patients aged 50 years and older were recruited, and devided into an etomidate and propofol group, according to whether they were sedated by repeated bolus doses of etomidate and propofol. Recorded data included demographic characteristics, heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturation (Spo2), patients', anesthesiologists' and urologists' satisfaction, sedation and pain scores, hemodynamic and respiratory side effects. Results : Sedation scores were comparable between groups but, compared to etomidate, propofol induced a greater decrease in systolic, diastolic and mean arterial blood pressures (P-values < 0.01). HR showed no significant difference between groups. Propofol showed a lower RR only at the time before transfer to the ward (P-value 0.0001). Anesthesiologist satisfaction was significantly higher with etomidate than propofol (P-value 0.04). Conclusions : Our study demonstrates that both etomidate and propofol can induce satisfactory sedation in patients undergoing outpatient urologic surgeries. Major hemodynamic and respiratory complications were more frequent with propofol than etomidate. However, myoclonus and pain at the injection were higher in the etomidate group.