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• W2043790226 abstract "Cette étude contrôlée compare l'efficacité et la tolérance de l'étomidate et du thiopental dans l'anesthésie pour cardioversion. Quatre-vingts patients présentant une tachycardie supraventriculaire ont subi de façon aléatoire une anesthésie soit par thiopental (3 mg · kg−1), soit par étomidate (0,3 mg · kg−1). La comparaison porte sur les durées d'anesthésie, sur la qualité du réveil, sur la tolérance ventilatoire et hémodynamique et sur la survenue d'effets secondaires. La durée de l'anesthésie sous étomidate est supérieure à celle sous thiopental, provoquant un nombre total de réinjections moindre et un temps de réveil allongé. La proportion de malades réalisant le test graphique est inférieure sous étomidate à la 15e min, mais identique dans les deux groupes à 30 min. Les apnées sont plus rares sous étomidate ; les variations tensionnelles sont plus fréquentes dans 84 % des cas, sous forme d'une hausse. Il n'a pas été mis en évidence de différence dans les fréquences de retour en rythme sinusal. Les effets secondaires autres que l'apnée sont plus fréquents dans le groupe étomidate (myoclonies, douleur à l'injection). L'étomidate peut être utilisé comme anesthésique pour la cardioversion, en raison notamment de sa bonne tolérance ventilatoire. A controlled study was carried out, comparing etomidate and thiopentone used for anaesthesia for cardioversion. Eighty patients presenting with supraventricular tachyarrhythmias were randomly allocated to two groups with stratification for duration of supraventricular tachyarrhythmias and cardiothoracic ratio. After premedication with 10 mg of diazepam, anaesthesia was induced and maintained if necessary with etomidate (0.3 and 0.15 mg · kg−1 respectively) or thiopentone (3 and 1.5 mg · kg−1 respectively). The following observations were made by an independent observer : energy of the electric discharge, systolic and diastolic arterial pressures, heart rate, apnoea with duration, quality of anaesthesia, side-effects if present, and induction, anaesthesia and recovery times. A drawing test and an ambulation test were carried out after recovery. Data were analysed using one-way analysis of variance (continuous variables) and chi-squared test with Yates correction for small numbers (categorical variables) with p < 0.05 considered significant. The thiopentone (THIO) and etomidate (ETO) groups were similar, except for premedication and number of NYHA class III and IV patients, being more common in ETO (p = 0.04 ; p = 0.05). Anaesthesia time was 4.6 ± 2.3 min in THIO and 9.9 ± 3.5 min in ETO (p < 10−9) with more reinjections in THIO (p = 0.003). Awakening time was shorter in THIO (p < 10−6) and graphic test was carried out better at 15 min in THIO. No difference was found later for graphic test and ambulation. Apnoea was more frequent in THIO (p = 0.002). 31 patients (77.5 %) in ETO and 22 patients (56.4 %) in THIO changed their arterial pressure (p = 0.046), with an increase in 83.8 and 68.2 % of patients respectively. There was no difference in the number of returns to sinus rythm. Side-effects were more frequent in ETO : pain at the injection site (p = 0.002) and myoclonus (p < 10−5). Etomidate gave a good anaesthesia with more side-effects than thiopentone, but lesser apnoea." @default.
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• W2043790226 date "1988-01-01" @default.
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• W2043790226 title "Comparison de l'étomidate et du thiopental pour l'anesthésie de la cardioversion" @default.
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• W2043790226 doi "https://doi.org/10.1016/s0750-7658(88)80140-0" @default.
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