Etomidate: Its pharmacologic and physiologic effects

Seminars in Cardiothoracic and Vascular Anesthesia

Volumn 1, Issue 2, 1997, Pages 132-141

  Avramov, Michail N ^a,b   White, Paul F ^a,b  

^a RUSH MEDICAL COLLEGE   (United States)

^b UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 79957678089     PISSN: 10892532     EISSN: 19405596     Source Type: Journal    
DOI: 10.1177/108925329700100205     Document Type: Article

References (97)

1. Zacharias M., Clarke RS, Dundee JW, Johnston SB: Evaluation of three preparations of etomidate. Br J Anaesth 50:925-929, 1978.
2. Zacharias M., Clarke RS, Dundee JW, Johnston SB: Venous sequelae following etomidate. Br J Anaesth 51:779-783, 1979.
3. Meuldermans WE, Heykants IJ: The plasma protein binding and distribution of etomidate in dog, rat and human blood. Archives Internationales de Pharmacodynamie et de Therapie 221:150-162,1976.
4. Van Hamme MJ, Ghoneim MM, Ambre JJ: Pharmacokinetics of etomidate, a new intravenous anesthetic. Anesthesiology 49:274-277, 1978.
5. Schuttler J., Wilms M., Lauven PM,et al:[Pharmacokinetics of etomidate in man (author's transl)]. [German] Pharmakokinetische Untersuchungen uber Etomidat beim Menschen. Anaesthesist 29:658-661, 1980.
6. Fragen RJ, Avram MJ, Henthorn TK, Caldwell NJ: A pharmacokinetically designed etomidate infusion regimen for hypnosis. Anesth Analg 62:654-660, 1983.
7. Heykants JJ, Meuldermans WE, Michiels LJ,et al:Distribution, metabolism and excretion of etomidate, a short-acting hypnotic drug, in the rat: Comparative study of (R)-(+)-(-)-Etomidate. Archives Internationales de Pharmacodynamie et de Therapie 216:113-129,1975.
8. Evans RH, Hill RG: GABA-mimetic action of etomidate. Experientia 34:1325-1327, 1978.
9. Robertson B.: Actions of anaesthetics and avermectin on GABAA chloride channels in mammalian dorsal root ganglion neurones. Br J Pharmacol 98:167-176,1989.
10. Willow M.: A comparison of the actions of pentobarbitone and etomidate on [3H]GABA binding to crude synaptosomal rat brain membranes. Brain Res 220:427-431, 1981.
11. Uchida I., Kamatchi G., Burt D., Yang J.: Etomidate potentiation of GABAA receptor-gated current depends on the subunit composition. Neurosci Lett 185:203-206, 1995.
12. Renou AM, Vernhiet J., Macrez P.,et al:Cerebral blood flow and metabolism during etomidate anaesthesia in man. BrJ Anaesth 50:1047-1051, 1978.
13. Moss E., Powell D., Gibson RM, McDowall DG: Effect of etomidate on intracranial pressure and cerebral perfusion pressure. Br J Anaesth 51:347-352, 1979.
14. Cold GE, Eskesen V., Eriksen H.,et al:CBF and CMRO2 during continuous etomidate infusion supplemented with N2O and fentanyl in patients with supratentorial cerebral tumour: A dose-response study. Acta Anaesthesiol Scand 29:490-494, 1985.
15. Cold GE, Madsen JB, Knudsen L.: Measurement of cerebral blood flow (CBF) with the Kety and Schmidt technique during craniotomy. Agressologie 32:345-351, 1991.
16. Sear JW, Walters FJ, Wilkins DG, Willatts SM: Etomidate by infusion for neuroanaesthesia: Kinetic and dynamic interactions with nitrous oxide. Anaesthesia 39:12-18, 1984.
17. Cold GE: Etomidate used for brain neurosurgical anaesthesia: The effect upon cerebral circulation and metabolism. Agressologie 32:412-416, 1991.
18. Dearden NM, McDowall DG: Comparison of etomidate and althesin in the reduction of increased intracranial pressure after head injury. Br J Anaesth 57:361-368, 1985.
19. Wagner RI, White PF, Kan PB,et al:Inhibition of adrenal steroidogenesis by the anesthetic etomidate. N Engl J Med 310:1415-1421, 1984.
20. Wauquier A.: Brain protective properties of etomidate and flunarizine. J Cereb Blood Flow Metab 2:S53-S56, 1982 (Suppl 1).
21. Wauquier A.: Profile of etomidate: A hypnotic, anticonvulsant and brain protective compound [Review]. Anaesthesia 38:26-33, 1983.
22. Ashton D., van Reempts J., Wauquier A.: Behavioural, electroencephalographic and histological study of the protective effect of etomidate against histotoxic dysoxia produced by cyanide. Archives Internationales de Pharmacodynamie et de Therapie 254:196-213, 1981.
23. Van Reempts J, Borgers M., Van Eyndhoven J, Hermans C.: Protective effects of etomidate in hypoxic-ischemic brain damage in the rat: A morphologic assessment. Exp Neurol 76:181-195, 1982.
24. Tulleken CA, van Dieren A., Jonkman J., Kalenda Z.: Clinical and experimental experience with etomidate as a brain protective agent. J Cereb Blood Flow Metab 2:S92-S97, 1982 (Suppl 1).
25. Sano T., Patel PM, Drummond JC, Cole DJ: A comparison of the cerebral protective effects of etomidate, thiopental, and isoflurane in a model of forebrain ischemia in the rat. Anesth Analg 76:990-997, 1993.
26. Koorn R., Brannan TS, Martinez-Tica J.,et al:Effect of etomidate on in vivo ischemia-induced dopamine release in the corpus striatum of the rat: A study using cerebral microdialysis. Anesth Analg 78:73-79, 1994.
27. Patel PM, Goskowicz RI, Drummond JC, Cole DJ: Etomidate reduces ischemia-induced glutamate release in the hippocampus in rats subjected to incomplete forebrain ischemia. Anesth Analg 80:933-939, 1995.
28. Cold GE, Eskesen V., Eriksen H., Blatt Lyon B.: Changes in CMRO2, EEG and concentration of etomidate in serum and brain tissue during craniotomy with continuous etomidate supplemented with N2O and fentanyl. Acta Anaesthesiol Scand 30:159-163, 1986.
29. Samson D., Batjer HH, Bowman G.,et al:A clinical study of the parameters and effects of temporary arterial occlusion in the management of intracranial aneurysms. Neurosurgery 34:22-28, 1994.
30. Drummond JC, Cole DJ, Patel PM, Reynolds LW: Focal cerebral ischemia during anesthesia with etomidate, isoflurane, or thiopental: A comparison of the extent of cerebral injury. Neurosurgery 37:742-748, 1995.
31. Guo J., White JA, Batjer HH: Limited protective effects of etomidate during brainstem ischemia in dogs. J Neurosurg 82:278-283, 1995.
32. Ghoneim MM, Yamada T.: Etomidate: A clinical and electroencephalographic comparison with thiopental. Anesth Analg 56:479-485, 1977.
33. Koht A., Schutz W., Schmidt G.,et al:Effects of etomidate, midazolam, and thiopental on median nerve somatosensory evoked potentials and the additive effects of fentanyl and nitrous oxide. Anesth Analg 67:435-441, 1988.
34. McPherson RW, Sell B., Traystman RJ: Effects of thiopental, fentanyl, and etomidate on upper extremity somatosensory evoked potentials in humans. Anesthesiology 65:584-589, 1986.
35. Sloan TB, Ronai AK, Toleikis JR, Koht A.: Improvement of intraoperative somatosensory evoked potentials by etomidate. Anesth Analg 67:582-585, 1988.
36. Kalkman CJ, Drummond JC, Ribberink AA,et al:Effects of propofol, etomidate, midazolam, and fentanyl on motor evoked responses to transcranial electrical or magnetic stimulation in humans. Anesthesiology 76:502-509, 1992.
37. Laughlin TP, Newberg LA: Prolonged myoclonus after etomidate anesthesia. Anesth Analg 64:80-82, 1985.
38. Reddy RV, Moorthy SS, Dierdorf SF,et al:Excitatory effects and electroencephalographic correlation of etomidate, thiopental, methohexital, and propofol. Anesth Analg 77:1008-1011, 1993.
39. Carlos R., Innerarity S.: Effect of premedication on etomidate anaesthesia. Br J Anaesth 51:1159-1162, 1979.
40. Ebrahim ZY, DeBoer GE, Luders H.,et al:Effect of etomidate on the electroencephalogram of patients with epilepsy. Anesth Analg 65:1004-1006, 1986.
41. Hoffmann P., Schockenhoff B.: [Etomidate as an anticonvulsive agent]. [German] Etomidat als antikonvulsive Substanz. Anaesthesist 33:142-144, 1984.
42. Avramov MN, Husain MM, White PF: The comparative effects of methohexital, propofol, and etomidate for electroconvulsive therapy. Anesth Analg 81:596-602, 1995.
43. Yeoman P., Hutchinson A., Byrne A.,et al:Etomidate infusions for the control of refractory status epilepticus. Intensive Care Medicine 15:255-259, 1989.
44. Modica PA, TempelhoffR., White PF: Pro- and anticonvulsant effects of anesthetics (Part II) [see comments]. [Review] Comment in: Anesth Analg 1990 Oct; 71:441, Comment in: Anesth Analg 1990 Dec; 71:708-709. Anesth Analg 70:433-444, 1990.
45. Hsieh JC, Shih YS, Hwang LD,et al:Activation of epileptogenic activities by etomidate in electrocorticoencephalography (ECoG) during operation for epilepsy. Ma Tsui Hsueh Tsa Chi Anaesthesiologica Sinica 28:127-135, 1990.
46. Giese JI, Stanley TH: Etomidate: A new intravenous anesthetic induction agent. [Review]. Pharmacotherapy 3:251-258, 1983.
47. Giese JI, Stockham RJ, Stanley TH,et al:Etomidate versus thiopental for induction of anesthesia. Anesth Analg 64:871-876, 1985.
48. Choi SD, Spaulding BC, Gross JB, Apfelbaum JI: Comparison of the ventilatory effects of etomidate and methohexital. Anesthesiology 62:442-447, 1985.
49. Morgan M., Lumley J., Whitwam JG: Respiratory effects of etomidate. Br J Anaesth 49:233-236, 1977.
50. Kettler D., Sonntag H., Donath U.,et al:[Haemodynamics, myocardial mechanics, oxygen requirement and oxygenation of the human heart during induction of anaesthesia with etomidate (author's transl)]. [German] Hamodynamik, Myokardmechanik, Sauerstoffbedarf und Sauerstoffversorgung des menschlichen Herzens unter Narkoseeinleitung mit Etomidate. Anaesthesist 23:116-121, 1974.
51. Criado A., Maseda J., Navarro E.,et al:Induction of anaesthesia with etomidate: Haemodynamic study of 36 patients. Br J Anaesth 52:803-806, 1980.
52. Doenicke A., Gabanyi D., Lemce H., Schurk-Bulich M: [Haemodynamics and myocardial function after administration of three short-acting IV hypnotics, etomidate, propanidid, methohexital (author's transl)]. [German] Kreislaufverhalten und Myokardfunktion nach drei kurzwirkenden i.v. Hypnotica Etomidate, Propanidid, Methohexital. Anaesthesist 23:108-115, 1974.
53. Gooding JM, Corssen G.: Effect of etomidate on the cardiovascular system. Anesth Analg 56:717-719, 1977.
54. Hempelmann G., Piepenbrock S., Hempelmann W., Karliczek G.: Influence of althesine and etomidate on blood gases (continuous PO2 monitoring) and hemodynamics in man. Acta Anaesthesiol Belg 25:402-412, 1974.
55. Scorgie B.: Etomidate infusion: Its use in anaesthesia for general surgery. Anaesthesia 38:63-65, 1983.
56. Gauss A., Heinrich H., Wilder-Smith OH: Echocardiographic assessment of the haemodynamic effects of propofol: A comparison with etomidate and thiopentone. Anaesthesia 46:99-105, 1991.
57. Stowe DF, Bosnjak ZJ, Kampine JP: Comparison of etomidate, ketamine, midazolam, propofol, and thiopental on function and metabolism of isolated hearts. Anesth Analg 74:547-558, 1992.
58. Kissin I., Motomura S., Aultman DF, Reves JG: Inotropic and anesthetic potencies of etomidate and thiopental in dogs. Anesth Analg 62:961-965, 1983.
59. Komai H., DeWitt DE, Rusy BF: Negative inotropic effect of etomidate in rabbit papillary muscle. Anesth Analg 64:400-404, 1985.
60. Mattheussen M., Housmans PR: Mechanism of the direct, negative inotropic effect of etomidate in isolated ferret ventricular myocardium. Anesthesiology 79:1284-1295, 1993.
61. Boyle WA, White PF, Rending SV: Negative inotropic effects of propofol versus etomidate and thiopental on rabbit papillary muscle. Anesth Analg 68:S35, 1989 (abstract).
62. Gelissen HP, Epema AH, Henning RH,et al:Inotropic effects of propofol, thiopental, midazolam, etomidate, and ketamine on isolated human atrial muscle. Anesthesiology 84:397-403, 1996.
63. Tarnow J., Hess W., Klein W.: Etomidate, alfathesin and thiopentone as induction agents for coronary artery surgery. Can Anaesth Soc J 27:338-344, 1980.
64. Lindeburg T., Spotoft H., Bredgaard Sorensen M, Skovsted P.: Cardiovascular effects of etomidate used for induction and in combination with fentanyl-pancuronium for maintenance of anaesthesia in patients with valvular heart disease. Acta Anaesthesiol Scand 26:205-208, 1982.
65. Gooding JM, Weng JT, Smith RA,et al:Cardiovascular and pulmonary responses following etomidate induction of anesthesia in patients with demonstrated cardiac disease. Anesth Analg 58:40-41, 1979.
66. Hempelmann G., Hempelmann W., Piepenbrock S.,et al:[The influence of etomidate on blood gases and haemodynamics in patients with myocardial disease (author's transl)]. [German] Die Beeinflussung der Blutgase und Hamodynamik durch Etomidate bei myokardial vorgeschadigten Patienten. Anaesthesist 23:423-429, 1974.
67. De Hert SG, Vermeyen KM, Adriaensen HF: Influence of thiopental, etomidate, and propofol on regional myocardial function in the normal and acute ischemic heart segment in dogs. Anesth Analg 70:600-607, 1990.
68. Patschke D., Bruckner JB, Eberlein HJ,et al:Effects of althesin, etomidate and fentanyl on haemodynamics and myocardial oxygen consumption in man. Can Anaesth Soc J 24:57-69,1977.
69. Stockham RJ, Stanley TH, Pace NI,et al:Induction of anesthesia with fentanyl or fentanyl plus etomidate in high-risk patients. J Cardiothorac Anesth 1:19-23, 1987.
70. Larsen R., Rathgeber J., Bagdahn A.,et al:Effects of propofol on cardiovascular dynamics and coronary blood flow in geriatric patients. A comparison with etomidate. Anaesthesia 43:25-31, 1988.
71. Haessler R., Madler C., Klasing S.,et al:Propofol/fentanyl versus etomidate/fentanyl for the induction of anesthesia in patients with aortic insufficiency and coronary artery disease. J Cardiothorac Vasc Anesth 6:173-180, 1992.
72. Ebert TJ, Muzi M., Berens R.,et al:Sympathetic responses to induction of anesthesia in humans with propofol or etomidate. Anesthesiology 76:725-733, 1992.
73. Poterack KA, Kampine JP, Schmeling WT: Effects of isoflurane, midazolam, and etomidate on cardiovascular responses to stimulation of central nervous system pressor sites in chronically instrumented cats. Anesth Analg 73:64-75, 1991.
74. Christopher MM, Eckfeldt JH, Eaton JW: Propylene glycol ingestion causes D-lactic acidosis. Lab Invest 62:114-118, 1990.
75. Demey HE, Daelemans RA, Verpooten GA: Propylene glycol-induced side effects during nitroglycerin therapy. Intensive Care Med 14:221-226, 1988.
76. Martin G., Finberg L.: Propylene glycol: A potentially toxic vehicle in liquid dosage form. Pediatrics 77:877-878, 1970.
77. Flinger CL, Jack R., Twiggs GA, Raisys VA: Hyperosmolality induced by propylene glycol. JAMA 253:1606-1609, 1985.
78. Bretschneider H.: Osmolalities of commercially supplied drugs often used in anesthesia. Anesth Analg 66:361-362, 1987.
79. Doenicke A., Roizen MF, Nebauer AE,et al:A comparison of two formulations for etomidate, 2-hydroxypropyl-betacyclodextrin (HPCD) and propylene glycol. Anesth Analg 79:933-939,1994.
80. Doenicke A., Nebauer AE, Hoernecke R.,et al:Osmolalities of propylene glycol containing drug formulations for parenteral use: Should propylene glycol be used as a solvent. Anesth Analg 75:431-435, 1992.
81. Doenicke A., Kugler A., Vollmann N.,et al:[Etomidate using a new solubilizer. Experimen tal clinical studies on venous tolerance and bioavailability]. [German] Etomidat mit einem neuen Losungsvermittler. Klinischexperimentelle Untersuchungen zur Venenvertraglichkeit und Bioverfugbarkeit. Anaesthesist 39:475-480, 1990.
82. Ledingham IM, Watt I.: Influence of sedation on mortality in critically ill multiple trauma patients. Lancet 1:1270, 1983.
83. Wagner RI, White PF: Etomidate inhibits adrenocortical function in surgical patients. Anesthesiology 61:647-651, 1984.
84. Fragen RJ, Shanks CA, Molteni A., Avram MJ: Effects of etomidate on hormonal responses to surgical stress. Anesthesiology 61:652-656, 1984.
85. Preziosi P., Vacca M.: Adrenocortical suppression and other endocrine effects of etomidate. [Review]. Life Sci 42:477-489, 1988.
86. Sear JW, Edwards CR, Atherden SM: Dual effect of etomidate on mineralocorticoid biosynthesis. Acta Anaesthesiol Belg 39:87-94, 1988.
87. Longnecker DE: Stress free: To be or not to be? Anesthesiology 61:643-644, 1984 (editorial).
88. Owen H., Spence AA: Etomidate. Br J Anaesth 56:555-557, 1984 (editorial).
89. Crozier TA, Schlaeger M., Wuttke W., Kettler D.: [TIVA with etomidate-fentanyl versus midazolam-fentanyl. The perioperative stress of coronary surgery overcomes the inhibition of cortisol synthesis caused by etomidatefentanyl anesthesia]. [German] TIVA mit Etomidat-Fentanyl versus Midazolam-Fentanyl. Der perioperative Stress der Koronarchirurgie uberwindet die Kortisolsynthesehemmung nach einer totalen in travenosen Anasthesie mit Etomidat-Fentanyl. Anaesthesist 43:605-613, 1994.
90. Urquhart MI, White PF: Comparison of sedative infusions during regional anesthesia: Methohexital, etomidate, and midazolam [published erratum appears in Anesth Analg 1989 Apr;68:550]. Anesth Analg 68:249-254, 1989.
91. Holdcroft A., Morgan M., Whitwam JG, Lumley J.: Effect of dose and premedication on induction complications with etomidate. Br J Anaesth 48:199-205, 1976.
92. Fragen RJ, Caldwell N.: Comparison of a new formulation of etomidate with thiopental: Side effects and awakening times. Anesthesiology 50:242-244, 1979.
93. Wells JK: Comparison of ICI 35868, etomidate and methohexitone for day-case anaesthesia. Br J Anaesth 57:732-735, 1985.
94. White PF: Continuous infusions of thiopental, methohexital, or etomidate as adjuvants to nitrous oxide for outpatient anesthesia. Anesth Analg 63:282, 1984.
95. Van Hemelrijck J, Gonzaless JM, White PF: Use of intravenous sedative agents, chapter 53, in Rogers M, Tinker J, Covino B, Longnecker D (eds): Principle and Practice of Anesthesiology, St. Louis, MO, Mosby, 1992, pp 1131-1154.
96. Zacharias M., Dundee JW, Clarke RS, Hegarty JE: Effect of preanaesthetic medication on etomidate. Br J Anaesth 51:127-133, 1979.
97. Gran L., Bleie H., Jeppson R., Maartmann-Moe H: [Etomidate in Intralipid. A solution for pain-free injection]. [German] Etomidat mit Intralipid. Eine Losung zur schmerzfreien Injektion. Anaesthesist 32:475-477, 1983.