Bispectral index-guided induction of anesthesia by ketofol infusion provides the same cardiovascular stability like that of etomidate infusion

Introduction Various techniques have been tried to maintain cardiovascular stability with anesthesia induction. This study compares the cardiovascular effects of propofol–ketamine mixture versus etomidate during the induction of anesthesia. Materials and methods A total of 50 patients undergoing elective surgeries were randomly assigned according to the induction agents into two groups: group K (n = 25) received propofol-ketamine mixture (ketofol), and group E (n = 25) received etomidate, both by bispectral index (BIS) guidance. Mean arterial pressure ( MAP), cardiac output (CO), heart rate, and systemic vascular resistance ( SVR) were measured 6 min preintubation and up to 16 min postintubation. P-value less than 0.05 was considered statistically significant. Results MAP and SVR were significantly increased (P 0.001) in both groups immediately and up to 4 min postintubation compared with baseline, whereas CO and stroke volume (SV) remain unchanged. Meanwhile, there was no significant difference between both groups with regard to CO, MAP, SVR, heart rate, and BIS at each time intervals. Conclusion BIS-guided/induction by propofol–ketamine mixture is effective as etomidate in maintaining cardiac stability; however, both techniques did not prevent any hemodynamic changes as hypotension and hypertension preintubation and postintubation, respectively.