Toward a Better Etomidate

Abstract

More than 45 years after its development, etomidate still sees widespread use as a hypnotic agent for singledose sedation of critically ill and hemodynamically unstable patients. Potent and prolonged inhibition of cortisol synthesis by etomidate, even following single-dose administration, is controversial and a legitimate concern for clinicians. This article will briefl y review etomidate pharmacology. It will also discuss some recent basic science and translational studies that have yielded several novel and clinically promising etomidate analogues designed to circumvent etomidate adrenal suppression.