Background : Induction of general anesthesia in patients with cardiac disease must guarantee hemody-namic stability and should result in a satisfactory anesthetic level. The purpose of this study was to analyze the hemodynamic effects of midazolam/sufentanil in comparisan with etomidate/sufentanil used for induction of anesthesia in patients with cardiac disease. Methods : All the patients (n= 30) in the study were about to undergo cardiac surgery and were divided into the midazolam group (n =15) and etomidate group (n= 15). The induction dose of midazolam was 0.18 mg/kg, etomidate 0.3 mg/kg, vecuronium 0.15 mg/kg, sufentanil 3 μg/kg, hemody- namics and oxygenation were recorded in the awake state (pre-induction), and 10 minutes after intubation (past-intubation). Results : The etomidate group had a shorter time of anesthetic induction, and some myoclonic movement (13%) was observed. After intubation, reductians of heart rate (13.8%), mean arterial pressure (18.4%), cardiac index (14.8%), left ventricular stroke work index (9.7- 38.5%), oxygen delivery index (7.43%), oxygen cansumption index (10.3%), and Qs/Qt (25.6%), and an increase in central venous pressure (0 - 50%) were observed in both groups. Decreases in right ventricular stroke work index and mean arterial pressure were observed in the midazolam group, but no change in right ventricular stroke work index and a decrease in mean arterial pressure was observed in the etomidate group. In the midazolam group the values of right ventricular stroke work index and mean arterial pressure were significsntly lower than in the etomidate group. The heart rate of the midazolam group in patients with CABG were significantly lower than in the etomidate group. Condusioos: The results of this study shows that etomidate was found to be as reliable and effective an agent for induction as midazolam. (Korean J Anesthesiol 2000; 38: 984~990)