Related Experiment Video
Updated: Jun 7, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Ketamine Versus Etomidate for Rapid Sequence Intubation: A Systematic Review and Meta-Analysis of Randomized Trials
Alisha Greer1,2, Mark Hewitt1,2, Parsa T Khazaneh2
1Department of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, ON, Canada.
Ketamine may increase hemodynamic instability but reduces vasopressor need and adrenal suppression compared to etomidate for emergent endotracheal intubation. The drugs show similar efficacy for first-attempt intubation and mortality outcomes.
Area of Science:
- Critical Care Medicine
- Anesthesiology
- Pharmacology
Background:
- Emergent endotracheal intubation requires safe and effective induction agents.
- Ketamine and etomidate are commonly used, but their comparative safety and efficacy profiles require elucidation.
Purpose of the Study:
- To compare the safety and efficacy of ketamine versus etomidate as induction agents for emergent endotracheal intubation.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched MEDLINE, Embase, Cochrane, and ClinicalTrials.gov up to April 2024.
- Included 7 RCTs with 2384 adult patients.
Main Results:
- Ketamine likely increases peri-intubation hemodynamic instability (RR 1.29) but decreases vasopressor initiation (RR 0.75) and adrenal suppression (RR 0.54) compared to etomidate.
- No significant difference in first-attempt intubation success (RR 1.01) or 3-day ICU SOFA scores.
- Low certainty evidence suggests no effect on mortality (RR 1.00).
Conclusions:
- Ketamine may lead to more hemodynamic instability but offers benefits in reduced vasopressor use and adrenal suppression.
- Ketamine and etomidate demonstrate comparable efficacy regarding intubation success and mortality.
More Related Videos
08:49Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
Published on: October 16, 2013
09:36Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
Related Concept Videos
Parenteral Anesthetics: Overview
Inhalational Anesthetics: Overview
Stages of General Anesthesia
Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Drug Delivery: Enteral Route