Related Experiment Video

Updated: Mar 31, 2026

Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery
09:47

Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery

Published on: June 2, 2022

2.9K

The Effects of Single-Dose Etomidate Versus Propofol on Cortisol Levels in Pediatric Patients Undergoing Urologic

Yi Du1, Yi-Jun Chen, Bin He

  • 1From the Department of Anesthesiology and Critical Care Medicine, Xinhua Hospital, affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Anesthesia and Analgesia
|October 27, 2015
PubMed

Insights

Etomidate significantly suppressed postoperative cortisol levels in children for approximately 24 hours compared to propofol, without affecting clinical outcomes. This study clarifies anesthetic effects on the hypothalamus-pituitary-adrenal axis in pediatric surgery.

Area of Science:

  • Pediatric Anesthesiology
  • Endocrinology
  • Pharmacology

Background:

  • General anesthetics' impact on the hypothalamus-pituitary-adrenal axis and cortisol release in children is not well understood.
  • Daily cortisol fluctuations complicate the assessment of anesthetic effects.
  • This study investigated etomidate versus propofol's effects on pediatric cortisol secretory patterns.

Purpose of the Study:

  • To compare the effects of etomidate and propofol on the normal cortisol secretory pattern in children undergoing urologic surgery.
  • To assess the duration and significance of cortisol suppression following etomidate administration.

Main Methods:

  • Prospective, randomized, double-blind, controlled study involving 80 children (3-12 years) undergoing urologic surgery.
  • Salivary cortisol levels were measured in 11 healthy volunteers and 15 study patients preoperatively.
  • Patients received either etomidate (n=38) or propofol (n=39) for induction, with cortisol levels monitored for 2 days postoperatively.

Main Results:

  • Etomidate group showed significantly lower cortisol levels than the propofol group from PACU discharge until the next morning (P < 0.0001).
  • Cortisol levels in the etomidate group remained significantly lower than pre-surgery levels throughout the monitored period (P < 0.0001).
  • No significant differences in clinical outcomes were observed between the etomidate and propofol groups (P > 0.070).

Conclusions:

  • A single induction dose of etomidate suppresses postoperative cortisol levels in healthy children undergoing urologic surgery for approximately 24 hours.
  • This cortisol suppression by etomidate was not linked to adverse clinical outcomes.
  • Etomidate's effect on the hypothalamus-pituitary-adrenal axis in pediatric patients warrants consideration.
Abstract

More Related Videos

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention08:49

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention

Published on: October 16, 2013

14.6K

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
920
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
243
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
2.3K
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
332
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
769
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
1.5K