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Elderly patients have high mortality and postoperative complications rate after surgery, especially postoperative cardiac complications. A meta-analysis revealed haemodynamic intraoperative events significantly increased the risk of postoperative cardiac complications.To limit the risk, optimize the intraoperative management of circulation is essential. Anesthetic drug may effect on the haemodynamic intraoperative, reduction of postoperative complications should aimed at choosing the optimal anesthetic drug with minimal effect on haemodynamic.So this study is to explore the comparative efficacy and safety of anesthetic drug (etomidate or propofol) in elderly patients
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| etomidate | Experimental | etomidate is given for maintenance of general anesthesia,combined with sufentanil and cisatracurium |
|
| propofol | Experimental | propofol is given for maintenance of general anesthesia,combined with sufentanil and cisatracurium |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Etomidate | Drug | etomidate is given intravenously |
| |
| propofol |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants with complications defined by ICD (International codes of diseases)-9 | From the moment of giving sufentanil to the moment of discharge from hospital,up to 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| the time to awake from anesthesia | From stopping etomidate or propofol infusion to awake, approximately 30 minutes | |
| the time to withdraw tracheal tube from anesthesia | From end of etomidate or propofol infusion to recovery of spontaneous breathing and withdrawal of tracheal tube,approximately 30 minutes |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lize Xiong, PhD | Xijing hosptial | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Xijing Hospital, Fourth Military Medical University | Xi'an | Shaanxi | 710032 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26496368 | Background | Du Y, Chen YJ, He B, Wang YW. The Effects of Single-Dose Etomidate Versus Propofol on Cortisol Levels in Pediatric Patients Undergoing Urologic Surgery: A Randomized Controlled Trial. Anesth Analg. 2015 Dec;121(6):1580-5. doi: 10.1213/ANE.0000000000000981. | |
| 26161330 | Background | Aghdaii N, Ziyaeifard M, Faritus SZ, Azarfarin R. Hemodynamic Responses to Two Different Anesthesia Regimens in Compromised Left Ventricular Function Patients Undergoing Coronary Artery Bypass Graft Surgery: Etomidate-Midazolam Versus Propofol-Ketamine. Anesth Pain Med. 2015 Jun 22;5(3):e27966. doi: 10.5812/aapm.27966v2. eCollection 2015 Jun. |
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| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D005045 | Etomidate |
| D015742 | Propofol |
| D017409 | Sufentanil |
| C101584 | cisatracurium |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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participants were anesthetized and were unaware of the grouping. Care providers did not know the grouping. Specific investigators who did the intervention were aware of the grouping. The outcome assessors and the data analyzers did not know the grouping.
| Drug |
propofol is given intravenously |
|
| Sufentanil | Drug | sufentanil is given intravenously |
|
| Cisatracurium | Drug | Cisatracurium is given intravenously |
|
| the time to discharge from post-anesthesia care unit | From admit into post-anesthesia care unit to discharge from post-anesthesia care unit,on an average of 30 minutes |
| the time to discharge from hospital | From end of surgery to discharge from hospital,on an average of 7 days |
| Post Operative Nausea And vomiting score | score:0,no nausea and vomiting; 1,nausea without vomiting; 2,vomiting | 6 hours, 24 hours, 48 hours and 72 hours after end of surgery，approximately 6 hours, 24 hours, 48 hours and 72 hours respectively |
| pain on visual analogue scale | 6 hours after end of surgery，approximately 6 hours |
| satisfaction on visual analogue scale by the patients | patients will be asked to score their satisfaction on anesthesia on a visual analogue, 0 is for extremely unsatisfied, 10 is for totally satisfied | 24 hours after end of surgery |
| comfort on visual analogue scale by the patients | patients will be asked to score their comfort during and after anesthesia on a visual analogue, 0 is for extremely unsatisfied, 10 is for totally satisfied | 24 hours after end of surgery |
| incidence of hypotension during anesthesia | hypotension is defined as decrease of systemic blood pressure more than 20% of baseline | from start of surgery to end of surgery, on an average of 2.5 hours |
| incidence of hypertension during anesthesia | hypotension is defined as increase of systemic blood pressure more than 20% of baseline | from start of surgery to end of surgery, on an average of 2.5 hours |
| percentage of patients needed vasoactive agents during anesthesia | from start of surgery to end of surgery, on an average of 2.5 hours |
| concentration of serum Cortisol by radioimmunoassay | 24hours,48hours and 72hours after extubation，approximately 24 hour, 48 hour and 72 hour respectively |
| concentration of serum aldosterone by radioimmunoassay | 24hours,48hours and 72hours after extubation，approximately 24 hour, 48 hour and 72 hour respectively |
| concentration of serum Adrenocorticotropichormone(ACTH) by radioimmunoassay | 24hours,48hours and 72hours after extubation，approximately 24 hour, 48 hour and 72 hour respectively |
| death by 6 months after surgery | from end of surgery to 6 months after surgery |
| death by 12 months after surgery | from end of surgery to 12 months after surgery |
| 26180512 | Background | Song JC, Lu ZJ, Jiao YF, Yang B, Gao H, Zhang J, Yu WF. Etomidate Anesthesia during ERCP Caused More Stable Haemodynamic Responses Compared with Propofol: A Randomized Clinical Trial. Int J Med Sci. 2015 Jul 3;12(7):559-65. doi: 10.7150/ijms.11521. eCollection 2015. |
| 25849685 | Background | Kaushal RP, Vatal A, Pathak R. Effect of etomidate and propofol induction on hemodynamic and endocrine response in patients undergoing coronary artery bypass grafting/mitral valve and aortic valve replacement surgery on cardiopulmonary bypass. Ann Card Anaesth. 2015 Apr-Jun;18(2):172-8. doi: 10.4103/0971-9784.154470. |
| 35947398 | Derived | Lu Z, Zheng H, Chen Z, Xu S, Chen S, Mi W, Wang T, Chai X, Guo Q, Zhou H, Yu Y, Zheng X, Zhang J, Ai Y, Yu B, Bao H, Zheng H, Huang W, Wu A, Deng X, Ma H, Ma W, Tao L, Yang X, Zhang J, Liu T, Ma HP, Liang W, Wang X, Zhang Y, Du W, Ma T, Xie Y, Xie Y, Li N, Yang Y, Zheng T, Zhang C, Zhao Y, Dong R, Zhang C, Zhang G, Liu K, Wu Y, Fan X, Tan W, Li N, Dong H, Xiong L. Effect of Etomidate vs Propofol for Total Intravenous Anesthesia on Major Postoperative Complications in Older Patients: A Randomized Clinical Trial. JAMA Surg. 2022 Oct 1;157(10):888-895. doi: 10.1001/jamasurg.2022.3338. |
| D010636 |
| Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D005283 | Fentanyl |
| D010880 | Piperidines |