Comparison of the Effect of Two Drug Combinations: Ketamine-Midazolam -Sufentanil with Etomidate-Sufentanil on Changes in Heart Rate and Blood Pressure After Laryngoscopy and Endotracheal Intubation

Abstract

Background: Due to the high prevalence of complications during and after laryngoscopy, especially hemodynamic disturbances, and the absence of a suitable solution for preventing these complications, this study was conducted to compare the effect of “Ketamine-Midazolam-Sufentanil” with “Etomidate-Sufentanil” combinations on changes in heart rate and blood pressure after laryngoscopy and endotracheal intubation.
 Methods: In this controlled, triple-blind randomized clinical trial, 96 laryngoscopy candidate patients were divided into three groups of 32 members and were given “Ketamine-Midazolam-Sufentanil” (KMS), “Etomidate-Sufentanil” (ES) and” Etomidate- Normal Saline” (NS) respectively before laryngoscopy. Hemodynamic parameter changes at baseline and 1,3,5 and 10 minutes after laryngoscopy, were measured and compared between the 3 groups.
 Results: During the study, the 3 groups KMS, ES, and NS had 0%, 15.6% and, 3.1% bradycardia respectively (p value = 0.024). Changes in systolic blood pressure were significantly different in the 3 groups (p value = 0.043). However, the incidence of tachycardia, hypertension, and hypotension were not significantly different among the 3 groups.
 Conclusion: Results of this study showed that using the “Ketamine-Midazolam-Sufentanil” combination before laryngoscopy can reduce hemodynamic disturbances during and after laryngoscopy. Patients who receive this drug combination seem to have more desirable hemodynamic stability during and after laryngoscopy.