Comparative Evaluation of Sevoflurane–Fentanyl Versus Etomidate–Fentanyl for Anaesthetic Induction in Patients Undergoing Coronary Artery Bypass Graft Surgery

Background: The aim of this study was to compare the haemodynamic effects of sevoflurane with that of etomidate during anaesthetic induction in patients with coronary artery disease having good left ventricular function undergoing CABG and to assess time taken to achieve loss of consciousness and incidence of airway complications during induction.  Methods: A double-blind prospective randomized, clinical study was performed on 100 patients with CAD having good left ventricular function (EF>50) scheduled for elective CABG surgery. Patients were randomly allocated to two group E and S. These patients received etomidate and sevoflurane at induction of anaesthesia, respectively. Haemodynamic variables (systolic and diastolic blood pressure [SBP, DBP], mean arterial pressure [MAP], central venous pressure[CVP]and heart rate [HR]) were measured and recorded at baseline, at induction and then at 1minute interval till 5 minutes post intubation.  Results: Induction of anaesthesia was significantly faster in patients with etomidate as compared to patients who received sevoflurane. No airway complication was noted in patients who received either sevoflurane or etomidate. Vasopressor requirement was slightly higher in sevoflurane group as compared to etomidate group. However, these changes in haemodynamic parameters were not significant between the groups.  Conclusion: Etomidate and Sevoflurane used as inducing agents in patients undergoing elective CABG, with good left ventricular systolic function produced comparable haemodynamic environment. Etomidate offers a faster rate of induction as compared to sevoflurane. No airway complications were found between two groups.