Etomidate Sedation

Etomidate sedation infusion can be used as a suitable alternative for neuroanesthesia when nitrous oxide is contraindicated. Etomidate sedation (100 micrograms/kg/ minute) has been used as a part of total intravenous anesthetic technique with a mean recovery time of about 10 minutes.

The infusion is associated with minimal incidences of side effects such as thrombophiebitis or myoclonic jerks. Etomidate sedation (0.15—0.3 mg/kg IV), has minimal effects on the duration of electrically induced seizures or may increase the seizure duration and thus, may be a useful alternative to drugs (propofol, thiopental) that decrease the duration of seizures in patients undergoing electroconvulsive therapy.

Etomidate sedation can be used for the induction of anaesthesia in patients with intracranial space-occupying lesions without increasing ICP or reducing CPP. Etomidate sedation does not abolish the haemodynamic response to laryngoscopy and intubation and requires prior administration of opioid before induction.

Etomidate is an effective induction agent for emergency department rapid sequence intubation. It has a rapid onset of anaesthesia and results in haemodynamic stability, even in hypovolaemic patients or those with limited cardiac reserve; and may be better than midazolam.

It has been found safe in paediatric age group patients. Haemorrhagic shock produces minimal changes in the pharmacokinetics and no change in the pharmacodynamics of etomidate leading to minimal adjustment in the dose of etomidate during haemorrhagic shock to achieve the same drug effect.

The principal limiting factor in the clinical use of Etomidate sedation for induction of anesthesia is the ability of this drug to transiently depress adrenocortical function. The incidence of postoperative nausea and vomiting was similar after thiopental and etomidate.

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