Cardiovascular Effects of Etomidate Used for Induction and in Combination with Fentanyl-Pancuronium for Maintenance of Anaesthesia in Patients with Valvular Heart Disease

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Abstract
The effects of induction of anesthesia by etomidate 3 mg/kg followed by continuous infusion of etomidate 2 mg/min, fentanyl 0.01 mg/kg and pancuronium 0.1 mg/kg were studied in 10 patients with valvular heart disease. No hemodynamic changes were seen after injection of etomidate, but after fentanyl was given there was a significant decline in cardiac index (10%), mean arterial systemic pressure (20%), systemic vascular resistance (14%), left ventricular minute work index (27%) and right ventricular minute work index (21%) compared to the control values. After supplementing with pancuronium, no further significant changes were seen. There was no significant change in the pulmonary vascular resistance during the entire study. Evidently, etomidate is a safe i.v. agent and is worth further study, in particular in patients with minimal cardiac reserve requiring high inspired O2 tension.