Inclusion Criteria:  - Age 18 - 65 years, ASA II-III Ejection fraction (EF) > 30%.  Exclusion Criteria:- Poor left ventricular function (ejection fraction < 30%).  Recent myocardial infarction (last seven days), Patients with uncontrolled chronic disease (uncontrolled diabetes mellitus (DM) and hypertension), Known history of hypersensitivity to midazolam, fentanyl, etomidate, Or ketamine, Severe respiratory, hepatic or renal failure, History of neurological disorders or convulsions, In addition, any need for further anesthetic drug administration other than the study protocol was another exclusion criterion of this study.