In a randomized, double-blind study, a single induction dose of etomidate suppressed postoperative cortisol levels in children, but this had no effect on clinical outcomes.
Etomidate transiently suppresses 11ß-hydroxylase, a key glucocorticoid synthetic enzyme, resulting in temporary reductions in circulating cortisol. A recent meta-analysis found no association between single-dose etomidate and adverse clinical outcomes in adults. The effect of general anesthetics on adrenal synthetic function in children is not well understood.
Researchers at an academic medical center in China randomized 77 healthy children (ages 3–12 years) undergoing urologic surgery to induction of anesthesia with etomidate (0.3 mg/kg IV) or propofol (2 mg/kg IV). To minimize confounding by diurnal variation in cortisol levels, all surgeries started at 11 a.m. Anesthesia was maintained with sevoflurane, remifentanil, and rocuronium. Saliv…
Reviewing Author
DisclosuresConsultant / Advisory boardVerathon, Inc. (Scientific Advisory Board Member)
Editorial boardsScientific American Emergency Medicine; Manual of Emergency Airway Management (Editor-in-Chief)
Leadership positions in professional societiesPrograms Subcommittee Chair for the Society for Academic Emergency Medicine–Residency and Fellowship Fair
DisclosuresConsultant / Advisory boardVerathon, Inc. (Scientific Advisory Board Member)
Editorial boardsScientific American Emergency Medicine; Manual of Emergency Airway Management (Editor-in-Chief)
Leadership positions in professional societiesPrograms Subcommittee Chair for the Society for Academic Emergency Medicine–Residency and Fellowship Fair