Episode 932: Induction Agent Hypotension

Induction agent selection during rapid sequence intubation involves accounting for hemodynamic stability in the post-intubation setting

Many emergency departments use ketamine or etomidate

A recent study sought to explore the rates of post-induction hypotension of ketamine compared with propofol

Ketamine and propofol were both significantly associated with post-induction hypotension

Ketamine adjusted odds ratio = 4.50
Propofol adjusted odds ratio = 4.88
50% of patients became hypotensive after induction with either propofol or ketamine

These findings suggest post-induction hypotension is mainly due to sympatholysis rather than the choice of agent itself