Etomidate – drug for anesthetic induction


Etomidate Vial

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