Comparison of hemodynamic changes caused by induction of anesthesia with Ketamine-Propofol, and Etomidate in patients over 65 years old

Comparison of hemodynamic changes caused by induction of anesthesia with Ketamine-Propofol, and Etomidate in patients over 65 years old

A parallel-group, triple-blind, randomized, phase 2 clinical trial on 90 patients. Random allocation software is used for randomization.

This is a three-blind randomized clinical trial that will be conducted on 90 patients in Al-Zahra Hospital, Isfahan. After the approval of the ethics committee of the university and obtaining the consent of the patients, the patients are randomly assigned into groups, in each group the desired intervention is applied and the clinical symptoms of the patient are recorded. The researcher who records the patient's symptoms, the analysts who collect the data analyzed during the study, and the patients did not know the type of intervention applied in each group, so they were all blind.

Inclusion criteria: age over 65 years, candidate for elective surgery under general anesthesia, ASA class I and II, informed consent to participate in the study. Non-Inclusion criteria: history of drug, alcohol, and benzodiazepine use, BMI higher than 30, history of seizures, adrenal insufficiency, high blood pressure

Intervention group A: Patients in this group first received 2 micrograms/kg of Fentanyl and 2mg of intravenous Midazolam. Then, they receive 0.6 mg/kg Atracurium and 1.5 mg/kg Lidocaine, as well as 0.3 mg/kg Etomidate at a rate of 0.1mg/kg/min to induce anesthesia. Intervention group B: Patients in this group first received 2 micrograms/kg of Fentanyl and 2mg of intravenous Midazolam. Then, they receive 0.6 mg/kg of Atracurium and 1.5 mg/kg of Lidocaine, as well as 1.5 mg/kg of Propofol at a rate of 0.5 cc/s and 0.5 mg/kg of Ketamine at a rate of 0.5 mg/kg/min to induce anesthesia.

Blood Pressure; Heart Rate; O2 Sat

Randomization will be done by the simple method in which each patient will be assigned a code using a random number table (Random allocation software) and Patients fall into one of two groups depending on whether these codes are even or odd. This continues until the number of patients in both groups reaches the required number.

This is a triple blind clinical trial; In this way, the patient is included in the study but does not know the type of intervention applied and is blind, the researcher who records the patient's symptoms is also different from the person who injects the drug and without knowing the type of drug only records the patient's symptoms during the study and therefore is kept blind. The analysts who analyze the data collected during the study also do not know the type of intervention applied in each group and are blind.