Understanding Anesthesiology - The Global Regional Anesthesia ...

Etomidate
Class
Short-acting hypnotic; anesthetic induction agent. Useful in hemodynamically-compromised
patients.
Mechanism of action
Potentiates the inhibitory GABA neurotransmitter resulting in depression of the reticular activating
system.
Dose
Induction: 0.2-0.6 mg/kg IV
Onset
Within one arm-brain circulation time (approximately 20 seconds).
Duration
Approximately 5-10 minutes after single induction dose.
Elimination
Rapid redistribution from central nervous system (CNS) to lean body tissue accounts for
brief duration of action. Ultimately metabolized by hepatic and plasma esterases to inactive
products.
Effects
CNS
CNS depressant, potentiating the depressant effects of opioids, sedatives and volatile anesthetics.
Decreases cerebral metabolic rate and intracranial pressure. The cerebroprotective effects
of etomidate make it useful in the management of the head-injured patient. Can cause
seizure-like activity.
CVS
Etomidate is notable for the lack of significant cardiovascular depression that it causes. Therefore
it is commonly chosen to facilitate intubation in the trauma patient, patients with hypovolemic
shock or other unstable patients.
Respiratory
Etomidate causes a brief period of apnea.
GI
Nausea and vomiting
Misc.
Etomidate suppresses corticosteroid synthesis in the adrenal cortex and can lead to primary
adrenal suppression. For this reason, its use in patients with sepsis is controversial. Etomidate
can result in trismus if administered too quickly.
Related Glossary Terms
Addisonian crisis, Adrenal suppression, Induction, Ketamine, Propofol, Shock, Sodium Thiopental
Index
Find Term
Chapter 3 - General Anesthesia
Chapter 6 - Drug Finder
Chapter 6 - Induction Agents