Etomidate
Background info
- Imidazole
- Short acting IV anesthetic
- Hypnotic effects
- Amnestic properties, no analgesic properties
- works through the GABA adrenergic system
- Used often in Rapid Sequence Intubation
- Short duration of action, rapid onset
- Excellent hemodynamic profile
- Cerebroprotective effects including reduction of intracranial pressure. Used with patients with traumatic brain injury.
- Etomidate has hemodynamic stability which is better than all other induction agents except possibly Ketamine.
- Post operative vomiting is more common with Etomidate than with other induction agents.
- Requires a slow push for intubation induction otherwise one will get trismus
- Onset of action is 30-60 seconds.
Etomidate and Adrenal Insufficiency
- Adrenal supression: inhibits cortisol production of the adrenal gland
- Etomidate reversibly inhibits 11-beta-hydroxylase
- Etomidate is no longer used for continuous sedation
Signs and Symptoms of Adrenal Insufficiency
- Hypotension
- Orthostatic Hypotension
- Weakness
- Dizziness
- Hypoglycemia
- Dehydration
- Weightloss
- Nausea
- Vomiting
- Diarrhea
- Cardiovascular collapse