NEWS HIGHLIGHTSMedia Articles Related to Amidate (Etomidate)
Brain Responses During Anesthesia Mimic Those During Natural Deep Sleep
Source: Pain / Anesthetics News From Medical News Today [2010.01.29]
The brains of people under anesthesia respond to stimuli as they do in the deepest part of sleep - lending credence to a developing theory of consciousness and suggesting a new method to assess loss of consciousness in conditions such as coma...
Excess Weight Poses Anesthesia Challenge
Source: MedicineNet High Blood Pressure Specialty [2010.01.20]
Title: Excess Weight Poses Anesthesia Challenge
Category: Health News
Created: 1/19/2010 4:10:00 PM
Last Editorial Review: 1/20/2010
Anesthesia, Exertional Heat Deaths May Be Linked
Source: MedicineNet Hyperthermia Specialty [2009.10.26]
Title: Anesthesia, Exertional Heat Deaths May Be Linked
Category: Health News
Created: 10/23/2009 4:10:00 PM
Last Editorial Review: 10/26/2009
Anesthesia in Youngest Kids May be Linked to Learning Disabilities
Source: MedicineNet Hernia Specialty [2009.03.25]
Title: Anesthesia in Youngest Kids May be Linked to Learning Disabilities
Category: Health News
Created: 3/25/2009 2:00:00 AM
Last Editorial Review: 3/25/2009
Stopping Pain Without Affecting Motor Function
Source: Pain / Anesthetics News From Medical News Today [2010.02.03]
One of the holy grails of local anesthesia is the ability to achieve a long-lasting nerve block that eliminates pain sensation while not affecting motor function. Now, researchers at Children's Hospital Boston have discovered an anesthetic approach that seems to do just that...
Published Studies Related to Amidate (Etomidate)
Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. [2009.07.25]
BACKGROUND: Critically ill patients often require emergency intubation. The use of etomidate as the sedative agent in this context has been challenged because it might cause a reversible adrenal insufficiency, potentially associated with increased in-hospital morbidity. We compared early and 28-day morbidity after a single dose of etomidate or ketamine used for emergency endotracheal intubation of critically ill patients... INTERPRETATION: Our results show that ketamine is a safe and valuable alternative to etomidate for endotracheal intubation in critically ill patients, and should be considered in those with sepsis. FUNDING: French Ministry of Health.
Comparison of etomidate-remifentanil and propofol-remifentanil sedation in patients scheduled for colonoscopy. [2009.05]
OBJECTIVE: The aim of the study was to compare haemodynamic responses, recovery and discharge times, and physician satisfaction of etomidate-remifentanil and propofol-remifentanil combinations in patients undergoing elective colonoscopy... CONCLUSION: Etomidate-remifentanil administration for sedation and analgesia during colonoscopy resulted in more stable haemodynamic responses and shorter recovery and discharge times.
A comparison of the effects of propofol and etomidate on the induction of anesthesia and on cardiopulmonary parameters in dogs. [2008.11]
OBJECTIVE: To determine the effects of propofol or etomidate on induction quality, arterial blood pressure, blood gases, and recovery quality in normal dogs...
Adrenal suppression following a single dose of etomidate for rapid sequence induction: a prospective randomized study. [2008.09]
BACKGROUND: The administration of etomidate for rapid sequence induction (RSI) has been linked to subsequent adrenocortical insufficiency in nontrauma patients. However, etomidate-related adrenocortical insufficiency has not been well studied in the trauma population. PURPOSE: We performed a prospective, randomized, controlled study to assess the effect of one dose of etomidate for RSI on adrenal function and its clinical significance during and after resuscitation in trauma patients... CONCLUSIONS: The use of etomidate for RSI in trauma patients led to chemical evidence of adrenocortical insufficiency and may have contributed to increased hospital and ICU lengths of stay and increased ventilator days. Further studies should be considered to evaluate the safety profile of this drug in trauma patients.
Low-dose intravenous midazolam reduces etomidate-induced myoclonus: a prospective, randomized study in patients undergoing elective cardioversion. [2007.11]
BACKGROUND: Myoclonic movements are a common problem in unpremedicated patients during induction of anesthesia with etomidate... CONCLUSIONS: IV midazolam 0.015 mg/kg administered 90 s before induction of anesthesia with etomidate is effective in reducing myoclonic movements and does not prolong recovery in unpremedicated patients after short procedures.
Clinical Trials Related to Amidate (Etomidate)
Post Operative Hemodynamic Function After Anesthetic Induction With Etomidate for Cardiac Surgery With ECC [Recruiting]
Because of its hemodynamic safety, etomidate is widely used for anaesthesia induction of
cardiac surgery. It can also cause adrenal insufficiency during the following 48 hours ( 11
betahydroxylase inhibition ). So it could increase hemodynamic dysfunction caused by the SIRS
following cardiopulmonary bypass.
A previous observational study found more adrenal insufficiency and need for vasopressive
support therapy in the etomidate group versus another propofol induced group.
The aim of our work is to compare hemodynamic dysfunction following induction with etomidate
for cardiac surgery with ECC. The control group would be induced by Propofol. 94 patients
would be included.
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.
Ketamine Versus Etomidate During Rapid Sequence Intubation: Consequences on Hospital Morbidity [Recruiting]
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.
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