The safety of etomidate: a new intravenous anaesthetic induction agent

Etomidate is a new non-barbiturate intravenous (i.v.) anaesthetic induction agent. This paper attempts to evaluate its overall safety based on studies on its effects on the cardiovascular and respiratory systems, intraocular pressure changes, apgar scores of newborns, plasma potassium changes and times to full recovery of consciousness. During etomidate anaesthesia there was good cardiorespiratory stability, reduced intraocular pressure, high apgar scores of babies delivered by caesarian section, and rapid recovery of consciousness. Unlike thiopentone, etomidate failed to attenuate suxamethonium-induced hyperkalaemia. The two major disadvantages of etomidate are the pain during i.v. injection and the development of myoclonic muscle movements during induction of anaesthesia. It is concluded that etomidate is quite safe from the above-stated points of view and rates very high when compared with other i.v. anaesthetic agents. However, it rates low with regards to the smoothness and pleasantness of induction of anaesthesia.