NEWS HIGHLIGHTSMedia Articles Related to Amidate (Etomidate)
Elderly Receive Higher Than Recommended Doses of Anesthesia
Source: Medscape Medical News Headlines [2012.05.11]
Higher doses are linked to more hypotension after induction, but the in-hospital mortality rate was higher in patients receiving lower doses.
Medscape Medical News
Local Anesthesia May Be Enough for TAVI (CME/CE)
Source: MedPage Today Surgery [2012.05.09]
(MedPage Today) -- Local anesthesia alone may be enough for transcatheter aortic valve implantation (TAVI), according to a feasibility study.
Multiple Exposure To Anesthesia Increases Risk Of ADHD In Young Children
Source: ADHD News From Medical News Today [2012.02.06]
Mayo Clinic researchers have found that multiple exposures to anesthesia at a young age are associated with higher rates of attention-deficit/hyperactivity disorder (ADHD). Children exposed to two or more anesthetics before age 3 had more than double the incidence of ADHD than children who had no exposure, says David Warner, M.D...
Anesthesia Exposure Linked To ADHD In Children
Source: ADHD News From Medical News Today [2012.02.03]
A study by researchers at Mayo Clinic, Rochester Minn., and published in Mayo Clinic Proceedings, reveals that children who have been under anesthesia many times when they are young have a greater risk of developing attention-deficit/hyperactivity disorder (ADHD). According to David Warner, M...
84% Of Anesthesiologists Involved In Surgical Catastrophes
Source: Litigation / Medical Malpractice News From Medical News Today [2012.03.03]
According to results from a survey published in the March issue of Anesthesia & Analgesia, the official journal of the International Anesthesia Research Society (IARS), over 80% of anesthesiologists have been involved in a fatal or serious incident to a patient during a surgical procedure...
Published Studies Related to Amidate (Etomidate)
Effect of Etomidate Versus Thiopental on Major Depressive Disorder in Electroconvulsive Therapy, a Randomized Double-Blind Controlled Clinical Trial. [2011.10.06]
BACKGROUND:: Although the therapeutic effect of electroconvulsive therapy (ECT) on major depressive disorder is widely investigated, there is a gap in literature regarding the possible effects of the medications used for induction of anesthesia in ECT. To the best of the authors' knowledge, this study is the first randomized double-blind clinical trial comparing the effect of etomidate and sodium thiopental on the depression symptoms in patients who have received ECT... CONCLUSIONS:: In conclusion, etomidate may improve major depressive disorder more than sodium thiopental in patients who are receiving ECT.
Haemodynamic consequences of etomidate administration in elective cardiac surgery: a randomized double-blinded study. [2011.10]
BACKGROUND: The consequences of inhibition of cortisol synthesis by a single dose of etomidate on subsequent vasopressor drug usage and the duration of relative adrenal insufficiency (RAI) after cardiac surgery are not known... CONCLUSIONS: A single bolus of etomidate blunts the hypothalamic-pituitary-adrenal axis response for more than 24 h in patients undergoing elective cardiac surgery, but this was not associated with an increase in vasopressor requirements.
Corticosteroid after etomidate in critically ill patients: A randomized controlled trial. [2011.09.15]
OBJECTIVE:: To investigate the effects of moderate-dose hydrocortisone on hemodynamic status in critically ill patients throughout the period of etomidate-related adrenal insufficiency... CONCLUSION:: These findings suggest that critically ill patients without septic shock do not benefit from moderate-dose hydrocortisone administered to overcome etomidate-related adrenal insufficiency.
Effect of a small priming dose on myoclonic movements after intravenous anaesthesia induction with Etomidate-Lipuro in children. [2011.08]
BACKGROUND: In children, the incidence of injection pain at i.v. anaesthetic induction with Etomidate-Lipuro is low when compared with propofol mixed with lidocaine (5%). However, the incidence of involuntary myoclonic movements (MM) after induction of anaesthesia is higher compared with propofol (85% vs. 15%). In adults, the incidence of MM is reported to be significantly reduced if a small priming dose is administered immediately before the main injection of etomidate. The aim of this prospective, randomized, double-blind, placebo-controlled clinical trial was to investigate if a small priming dose of etomidate effectively can reduce the incidence of MM also in children... CONCLUSIONS: Children in the age range of 5-10 yr appear to be especially prone to react with involuntary MM after i.v. induction of anaesthesia with etomidate. The use of a small, non-sedative, priming dose did not influence the incidence of involuntary MM after i.v. induction of anaesthesia with etomidate in children 1-15 yr of age.
Evaluation of the effects of thiopental, propofol, and etomidate on glomerular filtration rate measured by the use of dynamic computed tomography in dogs. [2011.01]
OBJECTIVE: To evaluate the effects of thiopental, propofol, and etomidate on glomerular filtration rate (GFR) measured by the use of dynamic computed tomography in dogs... Therefore, etomidate, propofol, or thiopental can be used in anesthesia-induction protocols that involve the use of isoflurane for maintenance of anesthesia without adversely affecting GFR measurements obtained by the use of dynamic computed tomography in dogs.
Clinical Trials Related to Amidate (Etomidate)
Does Administration of Etomidate and Propofol of the Anesthetic Induction of Elderly Hypertensive Patient Provide Superior Blood Pressure Stability in Response to Direct Laryngoscopy When Compared to Propofol or Etomidate Alone? [Not yet recruiting]
This study will attempt to show that a combination of drugs, Etomidate and Propofol, provide
a more stable blood pressure when used to put elderly hypertensive patients to sleep than
either drug used alone.
Ketamine Versus Etomidate for Procedural Sedation for Pediatric Orthopedic Reductions [Recruiting]
There are multiple retrospective studies detailing the use of etomidate in pediatric
procedural sedation but few to no prospective clinical trials. None have compared etomidate
to ketamine, currently the most commonly used sedative in the emergency department for
pediatric procedural sedation. We propose a randomized, controlled trial comparing etomidate
versus ketamine for procedural sedation for fracture reduction for children presenting with
extremity fracture requiring sedation for reduction. We hypothesize that etomidate in
combination with fentanyl will have similar reduction of distress and procedural recall as
ketamine in combination with midazolam.
The Effect of Etomidate on Patient Outcomes After Single Bolus Doses [Recruiting]
The primary aim is to determine the difference in hospital length of stay between septic
patients given etomidate and those given midazolam for induction during rapid sequence
intubation (RSI) in the emergency department. To achieve this aim we plan to perform a
prospective randomized trial measuring the length of stay of patients meeting sepsis
criteria and requiring intubation. The investigators will compare in-hospital mortality
rates between patients given etomidate and patients given midazolam for induction. In
addition to hospital length of stay, secondary endpoints between the two groups will include
length of stay in the intensive care unit, death within 48 hours of admission, and total
number of days intubated.
Research Hypothesis:
In adult patients presenting to the emergency department with sepsis and requiring rapid
sequence intubation, the length of stay of patients given etomidate will be greater than
that of patients given the alternative agent midazolam for induction.
The Effect of Etomidate on Outcomes of Trauma Patients [Not yet recruiting]
Rationale: The drug etomidate causes increased mortality if used for continuous sedation in
mechanically ventilated patients; however, etomidate continues to be widely used as a
single-bolus induction agent for endotracheal intubation because of its favorable
hemodynamic properties. Recent data have raised questions regarding the safety of using
etomidate for even a single bolus in patients at risk of adrenal insufficiency, emphasizing
the fact that single bolus doses of etomidate cause measurable adrenal suppression, and
consequently may cause increases in vasopressor requirements and in hospital length of stay.
Alternative FDA-approved induction agents, such as midazolam, may be safer than etomidate;
however, no studies have formally compared these agents.
Research Hypothesis: The investigators hypothesize that in critically ill trauma patients
presenting to the emergency department requiring rapid sequence intubation, the hospital
length of stay for patients given etomidate will be greater than for patients given
midazolam for induction.
Specific Aims: The specific aim is to determine the difference in hospital length of stay
between trauma patients given etomidate and those given midazolam for induction during rapid
sequence intubation in the emergency department. The investigators plan to compare the two
groups in terms of hospital length of hospital stay, length of stay in the intensive care
unit, and duration of intubation by performing a prospective, randomized, trial of
critically ill trauma patients presenting to the emergency department requiring intubation.
The investigators will also compare the mortality rates in these two groups while
controlling for severity of illness and the use of steroids while hospitalized.
Significance: If the use of etomidate to induce anesthesia prior to intubation adversely
affects the hospital length of stay of trauma patients, this length of stay might be reduced
in such patients by using alternative agents for induction. Since etomidate is currently in
widespread use as an induction agent, the results of this study could have significant
implications for patient management.
A Comparison of Etomidate and Ketamine for Anesthesia Induction in Coronary Artery Bypass Graft Surgery [Recruiting]
The aim of this study is to determine whether ketamine is an acceptable alternative to
etomidate for anesthesia induction in coronary artery bypass graft surgery in terms of
hemodynamic stability and also to compare these agents regarding their effect on adrenal
gland steroid synthesis in these patients.
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