open access

Vol 68, No 11 (2010)
Original articles
Published online: 2010-11-24
Submitted: 2012-12-28
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Comparison of propofol and etomidate anaesthesia for elective electrical cardioversion

Janusz Siedy, Piotr Knapik, Wojciech Saucha, Maria Gross
Kardiol Pol 2010;68(11):1249-1255.

open access

Vol 68, No 11 (2010)
Original articles
Published online: 2010-11-24
Submitted: 2012-12-28

Abstract


Background: Propofol has been previously shown to be superior to etomidate during electrical cardioversion (EC) of atrial tachyarrhythmias. However, literature on this topic is scarce and the optimal anaesthetic technique for EC has not yet been firmly established.
Aim: To compare anaesthetic management with propofol against a mixture of etomidate and low-dose fentanyl for EC.
Methods: One hundred patients, aged 32 to 87, underwent elective EC for various atrial arrhythmias. All patients were haemodynamically stable before the procedure and were randomly allocated into one of two groups. Group I (n = 50) was given propofol (bolus 1 mg/kg, followed by increments containing 20% of the initial dose). Group II (n = 50) received 1 mg/kg of fentanyl i.v. (single dose) and etomidate (bolus 0.15 mg/kg, followed by increments containing 20% of the initial dose). Heart rate and non-invasive blood pressure values were taken before induction of anaesthesia (T1), before EC (T2), after EC (T3) and when awake (T4). The number of shocks, the total amount of energy, the number of patients in whom EC failed to restore sinus rhythm, and the time taken to achieve maximal Aldrette score, as well as side effects, were all noted.
Results: Heart rate values were similar in both groups. Blood pressure was significantly lower at T2, T3 and T4 in patients who received propofol. Anaesthesia time was similar; however, maximal Aldrette score was achieved quicker in group I than in group II (4.7 ± 2.2 vs 6.7 ± 4.9 min, p < 0.01). Overall, the efficacy of EC was similar in both groups: 41 (82%) patients from group I and 46 (92%) patients from group II regained sinus rhythm (NS). Significantly more side effects, such as pain at the time of injection, muscle tremor, nausea and vomiting, were noted in group II.
Conclusions: In terms of side effects, propofol is superior to etomidate with fentanyl for elective EC of atrial tachyarrhythmias.
Kardiol Pol 2010; 68: 11: 1249-1255

Abstract


Background: Propofol has been previously shown to be superior to etomidate during electrical cardioversion (EC) of atrial tachyarrhythmias. However, literature on this topic is scarce and the optimal anaesthetic technique for EC has not yet been firmly established.
Aim: To compare anaesthetic management with propofol against a mixture of etomidate and low-dose fentanyl for EC.
Methods: One hundred patients, aged 32 to 87, underwent elective EC for various atrial arrhythmias. All patients were haemodynamically stable before the procedure and were randomly allocated into one of two groups. Group I (n = 50) was given propofol (bolus 1 mg/kg, followed by increments containing 20% of the initial dose). Group II (n = 50) received 1 mg/kg of fentanyl i.v. (single dose) and etomidate (bolus 0.15 mg/kg, followed by increments containing 20% of the initial dose). Heart rate and non-invasive blood pressure values were taken before induction of anaesthesia (T1), before EC (T2), after EC (T3) and when awake (T4). The number of shocks, the total amount of energy, the number of patients in whom EC failed to restore sinus rhythm, and the time taken to achieve maximal Aldrette score, as well as side effects, were all noted.
Results: Heart rate values were similar in both groups. Blood pressure was significantly lower at T2, T3 and T4 in patients who received propofol. Anaesthesia time was similar; however, maximal Aldrette score was achieved quicker in group I than in group II (4.7 ± 2.2 vs 6.7 ± 4.9 min, p < 0.01). Overall, the efficacy of EC was similar in both groups: 41 (82%) patients from group I and 46 (92%) patients from group II regained sinus rhythm (NS). Significantly more side effects, such as pain at the time of injection, muscle tremor, nausea and vomiting, were noted in group II.
Conclusions: In terms of side effects, propofol is superior to etomidate with fentanyl for elective EC of atrial tachyarrhythmias.
Kardiol Pol 2010; 68: 11: 1249-1255
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Keywords

cardioversion; anaesthesia; propofol; etomidate

About this article
Title

Comparison of propofol and etomidate anaesthesia for elective electrical cardioversion

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 68, No 11 (2010)

Pages

1249-1255

Published online

2010-11-24

Bibliographic record

Kardiol Pol 2010;68(11):1249-1255.

Keywords

cardioversion
anaesthesia
propofol
etomidate

Authors

Janusz Siedy
Piotr Knapik
Wojciech Saucha
Maria Gross

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