Haemodynamic consequences of etomidate administration in elective cardiac surgery: a randomized double-blinded study

Abstract

A single bolus of etomidate blunts the hypothalamic-pituitary-adrenal axis response for more than 24 h in patients undergoing elective cardiac surgery, but this was not associated with an increase in vasopressor requirements.

Safety and efficacy of etomidate and propofol anesthesia in elderly patients undergoing gastroscopy: A double-blind randomized clinical study

“…However, propofol causes marked depression on hemodynamic and respiratory parameters. Hypotension is a common side effect associated with propofol due to vasodilatation and negative inotropic effects (11). An induction dose of propofol results in a 25-30% incidence of apnea and a 25-40% reduction in systolic blood pressure (9,10).…”

“…A B routine fasting. In contrast, etomidate is associated with hemodynamic stability and minimal respiratory depression, which are unique characteristics among rapid-onset induction agents (11,18). These properties differentiate etomidate from other rapid-onset induction agents, as it has a wider margin of safety than propofol, particularly in patients with valvular heart disease, myocardial ischemia and elderly patients.…”

“…The most prominent undesirable effect of propofol Safety and efficacy of etomidate and propofol anesthesia in elderly patients undergoing gastroscopy: A double-blind randomized clinical study is its marked depression on cardiovascular and respiratory parameters, particularly in elderly patients (9)(10). The distinct pharmacological characteristics of etomidate include improved hemodynamic stability and minimal respiratory depression (11). This results in a wider margin of safety for patients with significant risk factors, including patients with valvular heart disease and myocardial ischemia, and elderly patients.…”

Hemodynamic Responses to Etomidate Versus Ketamine-Thiopental Sodium Combination for Anesthetic Induction in Coronary Artery Bypass Graft Surgery Patients with Low Ejection Fraction: A Double-Blind, Randomized, Clinical Trial

“…These properties make it especially useful for cardiac-compromised patients [7]. However, it has been shown that single bolus of etomidate, blunts the hypothalamic-pituitary-adrenal (HPA) axis response for more than 24 hour after operation in patients undergoing elective cardiac surgery [8]. Activation of HPA axis is an essential component of the general adaptation to illness and stress and contributes to the maintenance of cellular and organ homeostasis.…”

“…Activation of HPA axis is an essential component of the general adaptation to illness and stress and contributes to the maintenance of cellular and organ homeostasis. Some studies suggest an association between etomidate administration, adrenal insufficiency (caused by reversible inhibition of cortisol synthesis), and increased mortality [8,9]. On the other hand, it has been shown that relative adrenal insufficiency in elective cardiopulmonary bypass (CPB) surgery patients may induce postoperative vasopressor dependency [9].…”