• Xiang Zhou, Bi-Xi Li, Li-Min Chen, Jun Tao, Sui Zhang, Meng Ji, Ming-Chun Wu, Min Chen, Yan-Hui Zhang, Guo-Shen Gan, and Xiao-Yang Song.
• Department of Anesthesiology, Wuhan General Hospital of Guangzhou Command, Wuhan, 430070, Hubei, People's Republic of China.
• Surg Endosc. 2016 Nov 1; 30 (11): 5108-5116.

Background And AimsSedation with propofol alone during gastroscopy has many side effects. Etomidate has advantages in terms of circulation and respiration compared to propofol. We hypothesized that etomidate plus propofol during gastroscopy would be more safe and effective than propofol alone.MethodsFour hundred (n = 400) patients were randomly divided into a propofol group (P group) and a etomidate plus propofol group (EP group). The P group was given the first dose of 1 % propofol 1 mg/kg before gastroscopy, and the EP group was given 1 % propofol 0.5 mg/kg plus etomidate 0.1 mg/kg. Repeated doses of 10-20 mg propofol or 5-10 mg propofol plus 1-2 mg etomidate were administered to maintain an adequate level of sedation. The sedation depth was maintained by bispectral index value of 40-60.ResultsThe EP group had a lower incidence of systolic hypotension (13.0 vs. 32.5 %; P < 0.0001), bradycardia (8.5 vs. 16.5 %; P = 0.0226), mild hypoxemia (6.5 vs. 18.0 %; P = 0.0007), and severe hypoxemia (2.5 vs. 10.0 %; P = 0.0031) compared to the P group. Also, the satisfaction of anesthetist and gastroscopist with EP was higher than that of P group (P < 0.0001; P = 0.018, respectively).ConclusionEtomidate plus propofol had few effects on respiration and circulation in patients undergoing gastroscopy and was more safe and effective than propofol alone.

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