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Etomidate infusion and adrenocortical function. A study in elective surgery.

M Wanscher, E Tønnesen, M Hüttel

    Acta Anaesthesiologica Scandinavica
    |July 1, 1985
    PubMed
    Summary
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    Etomidate anesthesia completely blocks the adrenocortical response to corticotropin stimulation for over 24 hours. Thiopentone anesthesia did not show this suppression, suggesting etomidate is unsuitable for routine anesthesia.

    Area of Science:

    • Anesthesiology
    • Endocrinology

    Background:

    • Adrenocortical suppression is a potential side effect of anesthetic agents.
    • Etomidate and thiopentone are commonly used anesthetic agents.

    Purpose of the Study:

    • To investigate the effect of etomidate and thiopentone infusions on the adrenocortical response to corticotropin stimulation.
    • To compare the impact of these two anesthetic agents on adrenal function post-surgery.

    Main Methods:

    • A short tetracosactrin (Synacthen) test was administered to 11 patients undergoing abdominal hysterectomy.
    • Patients received either etomidate or thiopentone infusion for anesthesia maintenance, with pethidine as the narcotic.
    • Adrenocortical response was assessed following corticotropin stimulation.

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    Main Results:

    • Etomidate infusion (median 28.5 ug/kg/min) completely inhibited the adrenocortical response to corticotropin stimulation for at least 24 hours post-surgery.
    • No significant suppression of the adrenocortical response was observed in patients receiving thiopentone infusion.

    Conclusions:

    • Etomidate causes profound and prolonged suppression of the adrenocortical response to corticotropin.
    • Due to its significant impact on adrenal function, etomidate is not recommended for routine induction and maintenance of anesthesia.