Etomidate Injection

What is Etomidate Injection?
Etomidate Injection is a short-acting intravenous hypnotic agent derived from imidazole. It is a non-barbiturate sedative-hypnotic used primarily for the induction of general anesthesia. It is highly regarded in emergency and critical care medicine for its hemodynamic stability, meaning it typically does not cause a significant drop in blood pressure or heart rate, making it the preferred choice for patients with unstable cardiovascular systems.
Uses of Etomidate Injection
Induction of General Anesthesia: To rapidly induce unconsciousness before surgery.
Rapid Sequence Induction (RSI): The preferred agent for intubating critically ill or hemodynamically unstable patients in the ER or ICU.
Short Surgical Procedures: Providing sedation for brief interventions like joint reductions or cardioversion.
Diagnostic Procedures: Sedation for procedures such as endoscopy or bronchoscopy.
Maintenance of Anesthesia: Occasionally used as part of a balanced anesthesia technique for longer surgeries.
How Does Etomidate Injection Work?
Etomidate works as a potent and selective GABA-A receptor modulator. It binds to specific sites on the GABA-A receptor in the brain, enhancing the inhibitory effects of the neurotransmitter gamma-aminobutyric acid (GABA). This action slows down neuronal activity, resulting in rapid-onset hypnosis and sedation. Unlike other induction agents, Etomidate has minimal effect on the sympathetic nervous system and baroreceptor functions, which is why it maintains blood pressure so effectively.
FAQs on Etomidate Injection
1. Why is Etomidate preferred for "unstable" patients? Most induction agents (like Propofol) tend to lower blood pressure. Etomidate is unique because it provides a very stable heart rate and blood pressure profile. This makes it safer for patients suffering from trauma, sepsis, or heart failure where a sudden drop in pressure could be dangerous.
2. Does Etomidate cause "Adrenal Suppression"? Yes. A single dose of Etomidate can temporarily inhibit the enzyme 11-beta-hydroxylase, which is necessary for the body to produce cortisol (the stress hormone). This suppression usually lasts for 4 to 24 hours. While clinically manageable for one-time use, it is the reason why Etomidate is not used for long-term continuous infusions.
3. Is there a risk of involuntary muscle movements? Involuntary muscle movements, known as myoclonus, are common during the induction phase with Etomidate. These are not seizures and can often be minimized by pre-treating the patient with a small dose of an opioid or benzodiazepine.
Therapeutic Category
CNS & Neurology (General Anesthetic)
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