Comparison the Effects of Etomidate Infusion versus Ketamine-Midazolam-Fentanyl Combination in Sedation for Cataract Surgery

Etomidate has been used to induce anesthesia with minimum changes in hemodynamic profile in many surgeries. Nevertheless، its infusion for sedation during cataract surgery has been less evaluated. In a double-blind clinical trial study، 64 patients candidate for cataract surgery under sedation were randomly assigned to receive eitheretomidate-fentanyl (E/F) or ketamine-midazolam-fentanyl (K/M/F) combinations. Systolic and diastolic blood pressures، heart rate، oxygen saturation (SaO2)، nausea and vomiting، movement frequency، sedation score، recovery duration، and patients'' and surgeon''s satisfaction were recorded during the surgeries. No statistically significant differences were observed in basic systolic and diastolic blood pressures and heart rate between the groups. But، mean systolic and diastolic blood pressures were significantly higher in K/M/F group during and after the surgery (P < 0. 050). Systolic and diastolic blood pressures and heart rate did not have significant difference in E/F group (P > 0. 050) during surgery but there was significant difference in K/M/F group (P < 0. 050). SaO2 in recovery was significantly higher in E/F group (P < 0. 001). Incidence of nausea، vomiting and movement episodes، sedation score، and patients'' and surgeon''s satisfaction were the same in both groups. Recovery duration was significantly less in E/F group (P < 0. 001). Combination of etomidate and fentanyl for sedation could be as efficient and safe as ketamine، midazolam، and fentanyl combination in cataract surgery، with less hemodynamic profile changes and recovery time.