Can etomidate cause an Addisonian crisis?

The purpose of this study was to assess if it could have been possible to discover the side effects of etomidate by infusion in an earlier phase of its introduction on the market, using the routine parameters of everyday anesthesiological practice. The study was undertaken in twelve patients scheduled for major abdominal vascular surgery. The effect of etomidate-fentanyl and air anesthesia was compared with the effects of neurolept anesthesia. Arterial blood-pressure, central venous blood pressure, pulse rate, peripheral and central body temperature were recorded continuously. Blood samples were taken every two hours during anesthesia for the estimation of arterial blood gases, cortisol, sodium, potassium and chloride. Significant differences were found mainly for the peripheral-, core temperature difference, the cumulative sodium and cumulative fluid balance from which the diagnosis addisonian crisis could have been made. There were also differences in the incidence of early and late complications and in the recovery rate of the patients after etomidate infusions.