Comparison the Effects of Etomidate Infusion Versus Ketamine-Midazolam-Fentanyl Combination in Sedation for Cataract Surgery



Aghadavoudi O¹ ; Dehghan M² ; Montazeri K³ Show Affiliations
Source: Journal of Isfahan Medical School Published:2013

Abstract

Background: Etomidate has been used to induce anesthesia with minimum changes in hemodynamic profile in many surgeries. Nevertheless, its infusion for sedation during cataract surgery has been less evaluated. Methods: In a double blind clinical trial study, 64 patients candidate for cataract surgery under sedation were randomly assigned to receive eitheretomidate-fentanyl (E/F) or ketamine-midazolamfentanyl (K/M/F) combinations. Systolic and diastolic blood pressures, heart rate, oxygen saturation (SaO2), nausea and vomiting, movement frequency, sedation score, recovery duration, and patients' and surgeon's satisfaction were recorded during the surgeries. Findings: No statistically significant differences were observed in basic systolic and diastolic blood pressures and heart rate between the groups. But, mean systolic and diastolic blood pressures were significantly higher in K/M/F group during and after the surgery (P < 0.050). Systolic and diastolic blood pressures and heart rate did not have significant difference in E/F group (P > 0.050) during surgery but there was significant difference in K/M/F group (P < 0.050). SaO2 in recovery was significantly higher in E/F group (P < 0.001). Incidence of nausea, vomiting and movement episodes, sedation score, and patients' and surgeon's satisfaction were the same in both groups. Recovery duration was significantly less in E/F group (P < 0.001). Conclusion: Combination of etomidate and fentanyl for sedation could be as efficient and safe as ketamine, midazolam, and fentanyl combination in cataract surgery, with less hemodynamic profile changes and recovery time.