Effect of induction of anesthesia with etomidate on cigarette smokers? endocrine functions

Health problems related to cigarette smoking are well known. The components of tobacco cause CAD, BP and increased systemic vasculer resistance. Etomidate via adrenal suppression leads to decreased blood cortisol levels and increased cortisol precursors.In our study, we aimed to determine that the effects of etomidate which is used for increased endocrine response by surgical stress during induction of anesthesia on smoker and non-smoker patients.Induction of anesthesia with etomidate and propofol were applied to 80 patients who underwent elective non-cardiac surgery with ASA I and II risk groups. Patients were randomly divided into two groups as non-smoker and smoker. For induction of anesthesia 0.3 mg/kg etomidate or 2-2.5 mg/kg propofol given to patients in both groups and according to anesthetic agents and smoking status patients? groups number were increased to four.Demographic data, duration of surgeries, MAP, SpO2, and WBC were not different among groups. Cortisol levels were found significantly lower at the first hour in Group IE than Group IIP and Group IIE than Group IIP (p<0.05). Nausea-vomiting scores were found significantly higher at the first minute in Group IIE than Group IE and Group IP, also they were found significantly higher at 15th and 30th minutes in Group IIE than Group IE, Group IP and Group IIP (p<0.05).As a result, we determined in our study that when induction of anesthesia with etomidate in smokers compared with induction of anesthesia with propofol, etomidate was found to better control increased endocrine response due to endotracheal intubation and surgical stres. We found that induction of anesthesia with propofol reduced frequence of nausea-vomiting when compared with etomidate. Also we found that increased blood cortisol levels were effective in smoker patients whose induction of anesthesia was ensured with propofol.