HEMODYNAMIC-EFFECTS DURING INDUCTION, LARYNGOSCOPY, AND INTUBATION WITH ELTANOLONE (5-BETA-PREGNANOLONE) OR PROPOFOL - A STUDY IN ASA-I ANDASA-II PATIENTS

Study Objective: To evaluate the cardiovascular changes following indu ction of anesthesia, laryngoscopy, and intubation in patients receivin g a bolus dose of either eltanolone or propofol. Design: Randomized, c ontrolled, blind, prospective clinical study. Setting: General operati ng theaters of a university hospital. Patients: 40 ASA status I and II patients scheduled for elective surgery. Interventions: Patients were premedicated with oral temazepam 20 mg. Anesthesia was induced with e ither eltanolone 0.58 mg/kg or propofol 1.7 mg/kg, neuromuscular block ade was achieved with vecuronium 0.1 mg/kg, and anesthesia was maintai ned with enflurane 0.5% to 1.0% in nitrous oxide (67%). Measurements a nd Main Results: Blood pressure was measured using an automatic oscill ometric technique, heart rate (HR) was derived from the ECG, oxygen sa turation was measured by pulse oximetry, and cardiac output (Q) was me asured by a thoracic bioimpedance technique. Induction of anesthesia w ith either drug, eltanolone or propofol, decreased arterial systolic ( SAP) and diastolic (DAP) blood pressures, Q and stroke volume (SV). HR increased. Systemic vascular resistance (SVR) was unaltered. After la ryngoscopy and intubation, SAP and DAP increased secondary to an incre ase in SVR. HR also increased; SV increased in patients receiving elta nolone. Side effects (e.g., apnea occurring for more than 30 seconds, involuntary movements, limb hypertonus) occurred at a similar incidenc e with both treatments, but pain following injection was greater with propofol (59% vs. 9%). Conclusions: Patients receiving either eltanolo ne or propofol showed similar cardiovascular changes to induction of a nesthesia, although there were greater increases in arterial pressure and HR in those patients receiving eltanolone.