Etomidate vs Propofol in Older Surgical Patients

Abstract

To the Editor Lu et al reported that, compared with propofol, etomidate anesthesia did not increase overall major in-hospital morbidity after abdominal surgery in older patients, although it induced transient adrenocortical suppression. 1 Although etomidateinduced adrenal insufficiency is temporary, the additional effect of etomidate on adrenal function might exaggerate the adverse outcomes in the setting of baseline adrenal insufficiency. 2 Patients with adrenocortical dysfunction and recent use of glucocorticoids were not excluded from this trial, which may affect cortisol levels and interfere with the trial results.