Etomidate Infusion and Adrenocortical Function

Abstract

The adrenocortical response to a short tetracosactrin (Synacthen) test was studied in 11 patients receiving either etomidate infusion or thiopentone infusion used to maintain anaesthesia for abdominal hysterectomy. Pethidine was used as the narcotic component. The results showed that etomidate infusion (median 28.5 ug/kg/min) completely blocked the adrenocortical response to corticotropin stimulation for at least 24 h after surgery. No suppression was found in patients receiving thiopentone infusion. It is concluded that etomidate cannot be recommended for routine induction and maintenance of anaesthesia.

Etomidate exposure in early infant mice (P10) does not induce apoptosis or affect behaviour

“…Etomidate possesses a large number of qualities associated with the ideal anaesthetic induction agent and is now available in a formulation better adapted for clinical use . It does share the same predictable and fast onset‐offset characteristics of propofol and the excellent haemodynamical stability associated with the use of ketamine, also in the setting of the compromised cardiovascular patient as well as in trauma victims . It is also virtually pain‐free on injection (incidence of injection pain 5%), whereas propofol mixed with lignocaine still is associated with a high incidence of injection pain (20–50%) .…”

“…Etomidate is known to negatively affect adrenocortical function if administered as a continuous infusion or if repeated doses are given . There is also an ongoing debate in adults regarding the appropriateness of using even single intubation doses of etomidate in septic patients or trauma victims due to a perceived risk for interference with endogenous cortisol production …”

Clinical and Molecular Pharmacology of Etomidate

“…Adrenal suppression was found to last 6–8 hours in patients following a single induction dose of etomidate 72,73 and more than 24 hours following etomidate infusion. 74 …”

Cancer-Free or Overall Survival Rate Following Radical Prostatectomy is not Influenced by Perioperative Pain Management

“…Concerning anesthetic management, the transition from thiopental to propofol, from isoflurane to sevoflurane and abandoning nitrous oxide may itself have influenced the outcome of our patients [23][24][25]. The use of etomidate, which is known to inhibit the function of the adrenal cortex [26], could have influenced the outcome just as well, but was equally used in both groups. Therefore it should not have influenced the result of our study.…”