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Etomidate: Adrenal suppression

  • Nonbarbiturate hypnotic, no analgesic activity, used for induction & sup of anesthesia.
  • Decreases cerebral metabolism, cerebral blood flow, and intracranial pressure. (superior to propofol in maintaining cerebral perfusion pressure)
  • Effects on EEG: initial increase α amplitude followed by progressive decrease in activity
  • Periods of burst suppression occur at higher doses. Use with caution in patients with focal epilepsy
  • A single induction dose may inhibit 11β-hydroxylase ⇒Adrenocortical suppression
    • May last 4-8 hours.
  • Pharmacology
    • Induction dose: 0.1-0.4 mg/kg Onset 30-60 seconds DOA 3-10 minutes
    • A/e: thrombophlebitis, laryngospasm, hiccups, myoclonus, nausea/vomiting