Etomidate Anesthesia Research Articles

Prolonged Myoclonus after Etomidate Anesthesia

Un cas en neurochirurgie. Les myoclonies sont un effet de l'utilisation d'une perfusion continue. A la fin de la perfusion aucun myoclonus n'est observe indiquant l'anesthesie a la fois du systeme extrapyramidal et du cortex

Etomidate anaesthesia in patients with cirrhosis of the liver: pharmacokinetic data.

Five patients undergoing endoscopic injection of oesophageal varices were anaesthetised with etomidate 0.2 mg/kg followed by an infusion at a rate of 20 micrograms/kg/minute. Fentanyl 100-200 micrograms was also given intravenously and the patients' lungs were ventilated with oxygen in air. The postinfusion plasma etomidate concentration was described by a three compartment model with a mean half-life of 540 minutes (SEM 66.9) and volume of distribution of 8.9 litres/kg (SEM 0.6). Clearance was 12.7 ml/kg/minute (SEM 2.3). Compared to results in the literature obtained from normal patients, these cirrhotic patients had normal clearance rates, but the distribution volume and elimination half-life were twice as great. This suggests that cirrhotic patients metabolise etomidate normally, but the volume of distribution is doubled, thus resulting in prolonged elimination half-lives.

CEREBRAL BLOOD FLOW AND METABOLISM DURING ETOMIDATE ANAESTHESIA IN MAN

The effects of etomidate on regional cerebral blood flow (rc.b.f.) and cerebral metabolic rate for oxygen (CMRo2) were studied in seven patients undergoing diagnostic carotid angiography. Following determination of baseline rc.b.f. while awake, the patients were anaesthetized with a single dose of etomidate 15 mg. Thereafter, an infusion of etomidate (2 or 3 mg min-1) was administered. Etomidate decreased both rc.b.f.10 (mean decrease 34%) and CMRo2 (mean decrease 45%). It was concluded that etomidate is a potent cerebral metabolic depressant. Furthermore, the cerebrovascular reactivity to carbon dioxide was maintained under etomidate anaesthesia.

Further experience with etomidate.

We report our further anaesthetic experience with Etomidate in 100 patients. The cardiovascular and respiratory systems were not significantly affected but intraocular pressure was reduced. The occurrence of pain during injection of Etomidate was unaffected by analgesic premedication but was reduced by using a solution buffered to a higher pH and by choosing a big vein for injection. The myoclonic movements often seen with Etomidate anaesthesia were transient and have so far not created any major problem; they were reduced by a slower speed of injection but unaffected by diazepam premedication or pretreatment with low dose of a non-depolarizing muscle relaxant (pancuronium). Etomidate is a satisfactory alternative to thiopentone in situations where depression of the cardiovascular and respiratory systems are undersirable or where barbiturates are otherwise contraindicated and is a usefull addition to the induction agents in our anaesthetic practice.