Etomidate derivatives: fine-tuning of molecular structure and innovation in pharmacological effects

Anesthetics play a crucial role during surgery by effectively alleviating intraoperative pain and other discomforts. Compared to other anesthesia methods, intravenous anesthesia is simple to administer, acts rapidly, and has a high safety profile, with minimal impact on the patient's postoperative daily life and relatively low side effects. Etomidate, as an intravenous anesthetic, offers advantages such as rapid onset and stable anesthesia induction; however, its side effect of inhibiting adrenal cortical hormone synthesis limits its clinical application, often accompanied by paradoxical excitation phenomena. In recent years, researchers have focused on optimizing compound structures to develop lead compounds that provide excellent anesthetic effects while minimizing adrenal cortical suppression and other side effects. This article summarizes these structural optimization achievements, offering insights and references for future related research.