Induction: Etomidate vs Propofol in hypertensive TBI.

Our study shows that the decrease in cerebral flow velocities induced by propofol, persisted even after hemodynamic stability was attained after induction doses of propofol. On the contrary etomidate provided stable hemodynamic parameters as well as stable flow velocities.

The Effect of Propofol versus Etomidate Induction on Middle Cerebral Artery Flow Velocities and its Derived Parameters Using Transcranial Doppler Ultrasonography.

Radhika dash et al

https://www.sciforschenonline.org/journals/clinical-anesthesia/JCAM-2-125.php

We propose that large doses of propofol should be used cautiously in head-injured patients, because there is the potential to increase the injured brain’s vulnerability to secondary insults.

The effects of large-dose propofol on cerebrovascular pressure autoregulation in head-injured patients.

Steiner LA, et al. Anesth Analg. 2003.

https://www.ncbi.nlm.nih.gov/pubmed/12873955/

I conclude that Etomidate do have upper hand in preserving the cerebral blood flow, while large dose of propofol may cause secondary insult to the traumatic brain.

Worry for high BP can be handle later after intubation by using propofol + fentanyl as sedation.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s