Etomidate and its derivatives: time to say goodbye?

ORCID

Abstract

Etomidate, an intravenous hypnotic used for anaesthesia and critical care, is known for its undesirable side effects, including pain on injection, myoclonus, and adrenocortical depression. Despite its continued clinical use due to its hemodynamic stability and rapid onset and offset, alternatives like propofol, ketamine, and remimazolam offer fewer drawbacks. Recent efforts to improve etomidate through chemical modifications, such as methoxyethyl etomidate hydrochloride (ET-26), have shown limited success, with persistent issues like involuntary muscle movements and adrenocortical suppression. We suggest that it might be time to move on from etomidate and focus on developing new anaesthetic agents.

DOI

10.1016/j.bja.2024.09.011

Publication Date

2025-01-01

Publication Title

British Journal of Anaesthesia

Volume

134

Issue

1

ISSN

0007-0912

Embargo Period

9999-12-31

Keywords

adrenocortical depression, critical care sedation, etomidate, general anaesthetic, intravenous hypnotic, methoxyethyl etomidate, Humans, Hypnotics and Sedatives/pharmacology, Anesthetics, Intravenous/adverse effects, Etomidate/pharmacology

First Page

11

Last Page

13

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This item is under embargo until 31 December 9999

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