Etomidate versus Propofol as induction agent in patients undergoing Endoscopic Retrograde Cholangiopancreaticogram (ERCP)

Endoscopic retrograde pancreaticogram (ERCP) requires patient to be sedated and pain free in prone position. Propofol sedation may cause cardiorespiratory depression. Etomidate is a good alternative with stable hemodynamic and respiratory parameters. We have compared these two drugs on their cardiorespiratory, induction time and recovery profiles.

A total of 100 patients undergoing ERCP were randomly distributed to etomidate or propofol groups. Patients in the etomidate group received etomidate induction and maintenance, while propofol group received propofol anaesthesia. Cardiorespiratory parameters, time for induction and recovery along with adverse effects were noted.

The induction time was longer in the etomidate group than the propofol group.(p<0.001) The time for attaining Modified Aldrette score 9 was longer in the etomidate group(p<0.001). The percentage of fall in MAP and HR was higher in propofol group(p<0.001). SpO2 fall was also significant in propofol group. One patient in etomidate group developed myoclonus. Adverse effects like bradycardia, hypotension, hypoxia were significantly more in the propofol group. Conclusion: Etomidate is a safe and cardiostable induction agent in patients with obstructive jaundice undergoing ERCP.