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PubMed1997

Differential subunit dependence of the actions of the general anesthetics alphaxalone and etomidate at gamma-aminobutyric acid type A receptors expressed in Xenopus laevis oocytes.

The effects of subunit composition of the gamma-aminobutyric acid (GABA) type A receptor on the multiple actions of the general anesthetics alphaxalone and etomidate were investigated. The abilities of the two drugs to activate directly Cl- currents and to modulate GABA-evoked Cl- currents mediated by human recombinant GABA(A) receptors composed of alpha1, gamma2S, and either beta1, beta2, or beta3 subunit expressed in Xenopus laevis oocytes were compared. Both alphaxalone and etomidate evoked Cl currents in alpha1 beta1 gamma2S, alpha1 beta2 gamma2S, and alpha1 beta3 gamma2S receptors, an action that was blocked by both SR 95531 and picrotoxin. However, although maximal current activation by alphaxalone varied only slightly with the specific beta subunit isoform present, the efficacy of etomidate showed a rank order of beta3 > beta2 >>> beta1. In addition, beta1 homomeric receptors were markedly activated by etomidate but not by alphaxalone. Conversely, receptors consisting of alpha1 and gamma2S subunits were markedly activated by alphaxalone but not by etomidate. The modulatory effect of alphaxalone was also not markedly influenced by the beta-specific subunit isoform, whereas the modulatory efficacy of etomidate showed a rank order of beta3 > beta2 >> beta1. These results further demonstrate that the actions of general anesthetics at GABA(A) receptors are influenced by receptor subunit composition, and they suggest that the effects of alphaxalone and etomidate are mediated by different binding sites on the receptor complex.

Anesthetics↗
PubMed1989

Cerebral metabolic depression and brain protection produced by midazolam and etomidate in the rat.

Midazolam and etomidate have been shown to depress cerebral metabolism and may protect the brain during ischemia. However, it has been reported that etomidate may produce EEG spiking activity and seizures, which could adversely affect outcome. We compared the effects of midazolam and etomidate on EEG, cerebral blood flow (CBF), and cerebral cortical oxygen consumption (CMRO2) as well as neurologic outcome following incomplete cerebral ischemia in the rat. CBF was measured with radioactive microspheres and cortical CMRO2 was calculated by multiplying cortical CBF by the arterial-sagittal sinus oxygen content. Incomplete ischemia was produced by unilateral carotid artery occlusion combined with hemorrhagic hypotension. In low doses (0.02 mg/kg/min i.v.), both midazolam and etomidate depressed EEG, decreased CMRO2, and improved outcome from ischemia compared to nitrous oxide control rats. At a higher dose (0.2 mg/kg/min i.v.), midazolam further depressed EEG and CMRO2 and again improved outcome compared to N2O controls. In contrast, high dose etomidate (0.2 mg/kg/min) produced spiking EEG activity without further depression of CMRO2 and a worsening of outcome following cerebral ischemia. These results support previous reports that midazolam and etomidate may protect the brain from incomplete cerebral ischemia but suggest that EEG spiking activity associated with high dose etomidate may be associated with a worse outcome.

Journal Article↗
PubMedDate not supplied

Etomidate: a new intravenous anesthetic induction agent.

Currently available anesthetic induction agents provide adequate hypnosis but are not ideal, particularly in the high risk patient (ASA class III-V), because most cause myocardial and/or respiratory depression and some have other important side effects. Etomidate was recently marketed as an intravenous anesthetic induction agent. It is a non-barbiturate hypnotic without analgesic properties that has less cardiovascular and respiratory depressant actions than sodium thiopental, even in patients with minimal cardiovascular reserve. Laboratory studies indicate that etomidate is approximately 25 times more potent and has a therapeutic index six times greater than sodium thiopental. In contrast to most other induction agents, etomidate does not cause histamine release. Furthermore, tolerance does not occur with repeated administration. Etomidate's rapid distribution half life (t 1/2 alpha = 2.81 +/- 1.64 min), short elimination half life 1/2 beta = 3.88 +/- 1.11 hr) and rapid clearance (954 +/- 178 ml/min) explain its rapid onset and short duration of action. The compound produces electroencephalographic changes and effects on cerebral blood flow, metabolism and intracranial pressure that are similar to sodium thiopental, suggesting that it may have a place in neurosurgery and as a "brain protective" agent in patients at risk of a brain hypoxic insult. Etomidate did not affect hepatorenal and hematologic function after repeated injections in animal toxicology studies, but few investigations addressing its effects on hepatic, renal, and neuromuscular function in man have been accomplished. The most noticeable side effects of etomidate include myoclonia, pain on injection and postoperative nausea and vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Intravenous↗
PubMed1993

Different inhibitory effect of etomidate and ketoconazole on the human adrenal steroid biosynthesis.

The narcotic agent etomidate and the antimycotic drug ketoconazole are known to block steroid biosynthesis in man. To study the different effects of these imidazole derivatives on human adrenal steroid biosynthesis we incubated slices of human adrenal glands with 3H-labeled precursors and increasing concentrations of etomidate or ketoconazole (0-2000 microM). After extraction the labeled metabolites were separated by thin-layer chromatography and quantified by scintillation counting. Etomidate inhibited most potently 11 beta-hydroxylase activity by suppressing the formation of corticosterone from 11-deoxycorticosterone to 1% of control [50% inhibitory concentration (IC50) 0.03 microM] while ketoconazole suppressed 11 beta-hydroxylase to only 39% of control activity (IC50 15 microM). Ketoconazole however, most potently blocked the conversion of 17 alpha-hydroxy-progesterone to androstenedione by C17,20-desmolase to about 15% of control activity (IC50 1 microM) while etomidate showed a much weaker effect on this enzyme with a suppression to 50% of C17,20-desmolase control activity at a concentration of 380 microM. Both imidazole drugs showed a similar strong inhibitory effect on the activity of 17 alpha-hydroxylase (IC50 6-18 microM) and 16 alpha-hydroxylase (IC50 4-8 microM) and did not affect 21-hydroxylase. These in vitro data indicate a predominant inhibitory effect of etomidate on corticosteroid biosynthesis by relative selective inhibition of 11 beta-hydroxylase and of ketoconazole on the adrenal androgen biosynthesis by a predominant inhibition of C17,20-desmolase. This differential inhibitory effect of etomidate and ketoconazole on human steroid biosynthesis may be of clinical importance for a possible therapeutic use of these imidazole derivatives in endocrine disorders.

Adrenal Glands↗
PubMed1983

Anaesthetic induction with alfentanil: comparison with thiopental, midazolam, and etomidate.

The speed, side effects and cardiovascular changes associated with anaesthetic induction and endotracheal intubation following alfentanil (20 micrograms/kg/min, IV), thiopental (84 micrograms/kg/min, IV), etomidate (5 micrograms/kg/min, IV) and midazolam (20 micrograms/kg/min, IV) prior to halothane-nitrous oxide general anaesthesia were evaluated and compared in 80 patients undergoing elective general surgical operations. Anaesthetic induction was fastest with etomidate and thiopental (approximately one minute) and slowest with midazolam (about two minutes). Systolic arterial blood pressure (SBP) was decreased at the moment of unconsciousness with thiopental but unchanged with the other compounds. Heart rate (HR) was increased at unconsciousness with midazolam and thiopental but unchanged with etomidate and alfentanil. After intubation HR was increased in all groups except those induced with alfentanil. Arrhythmias were infrequent (5 per cent or less in all groups). Rigidity during induction only occurred with alfentanil (55 per cent) and pain on injection only with etomidate (35 per cent) and alfentanil (5 per cent). Postoperative vomiting was infrequent in all groups (15 per cent) except etomidate (55 per cent). No patient remembered any aspect of laryngoscopy or the operation and all rapidly regained consciousness at the end of operation. The results of this study demonstrate that with the exception of rigidity (which is easily overcome with succinylcholine) and a slightly slower onset of action, alfentanil compares favourably as an induction agent with thiopental and is better than midazolam and etomidate. Alfentanil is superior to all three other induction agents with respect to cardiovascular stability during induction and intubation.

Adjuvants, Anesthesia↗
PubMed1992

Intracranial pressure during induction of anaesthesia and tracheal intubation with etomidate-induced EEG burst suppression.

This study was designed to determine if induction of anaesthesia with etomidate titrated to an early EEG burst suppression pattern would produce minimal changes in cerebral perfusion pressure, and prevent increases in intracranial pressure (ICP) associated with tracheal intubation. Eight patients, 18-71 yr, with intracranial space-occupying lesions, were studied. In each patient ICP was monitored via a lateral ventriculostomy catheter placed preoperatively. In the operating room, an ECG, a radial arterial line, and a two-channel computerized EEG were placed. Control (awake) measurements of MAP (mmHg), ICP (mmHg), CPP (mmHg), heart rate (HR-bpm), EEG power (picowatts-pW), and spectral edge frequency (SEF, Hz) were obtained. Anaesthesia was induced with etomidate, 0.2 mg.kg-1 iv, followed immediately by an etomidate infusion, 20 mg.min-1, iv, and vecuronium 0.2 mg.kg-1 iv. When early burst suppression was achieved, the etomidate infusion was stopped and tracheal intubation performed. The etomidate dose (bolus plus infusion) required to reach burst suppression was 1.28 +/- 0.11 mg.kg-1. Compared with awake control values (mean +/- SE), the period from induction to burst suppression was associated with a 50% decrease in ICP (22 +/- 1 vs 11 +/- 1 mmHg, P less than 0.01), but there were no changes in MAP, CPP, or HR. The decrease in ICP was maintained during the first 30 sec and the following 60 sec after intubation as MAP and HR remained unchanged. Our results suggest that when etomidate was administered to early burst suppression pattern on EEG, minimal changes in CPP occurred during induction of anaesthesia and a marked reduction in ICP was maintained following tracheal intubation.

Adolescent↗
PubMed1997

[Etomidate inhibits neuronal potassium channels in humans].

INTRODUCTION: There is no data available on the action of etomidate on ion currents in human neuronal cells. Therefore the effects of etomidate on a human neuronal delayed rectifier potassium current were investigated. METHOD: Outward rectifying potassium currents of human neuroblastoma SH-SY5Y cells were measured using the whole cell patch-clamp technique. Cells were grown in RPMI-medium (+Pen/Strep and FCS) at 37 degrees C and 5% CO2. The holding potential was -80 mV. Potassium currents were evoked by depolarizing the membrane potential to values from -50 mV to +90 mV in 10 mV steps using an EPC-7 patch-clamp amplifier (List medical electronics) and pclamp version 5.71 (Axon instruments). RESULTS: Etomidate differentially inhibited steady-state and peak potassium current with IC50-values of 170 microM for peak current suppression and 120 microM for steady-state current respectively. Etomidate induced inactivation-like behaviour of the potassium current and changed the voltage dependence of potassium current activation. CONCLUSION: The results demonstrate that etomidate has more than one effect on the potassium current, indicating the complexity of general anaesthetic actions on neuronal targets. The actions of etomidate on human neuronal potassium currents may potentially contribute to the myocloni observed with this general anaesthetic agent during induction of anaesthesia.

Anesthetics, Intravenous↗
PubMed1988

Adrenocortical suppression and other endocrine effects of etomidate.

(+/-) Etomidate is a short-acting general anaesthetic given by the intravenous route. It has strong adrenal suppression capability initially shown in the rat and then observed in man. At present, the drug seems the most effective adrenocortical inhibitor on a molar basis in vitro. 11 beta-hydroxylase is the most sensitive target enzyme; 16 alpha-, 17 alpha-hydroxylase and cholesterol side-chain cleavage are inhibited by higher concentrations. (+) Etomidate was more active than the (+/-) and far more than the (-) stereoisomer. Etomidate blood concentrations greatly exceed those needed to block adrenal steroidogenesis both when used inappropriately by infusion for long-term sedation (such previously unrecognized drug-induced adrenal suppression has often proved fatal in severely-injured patients) and also when given in very low doses as an induction anaesthetic. Reactive ACTH increase is currently observed. Etomidate, in vivo, does not appear to affect testicular steroidogenesis although it shares an imidazole moiety with fungicide phenylimidazoles endowed with such an action. However, testosterone production may be reduced by high concentrations in vitro. Other gonadal hormones seem unchanged. Both basal and stress-induced blood prolactin levels are lowered by etomidate in the rat but probably not in man arguably through interference at brain level where the GABA-benzodiazepine receptor complex could be directly involved. Hence, endocrine and neuroendocrine interferences are unique non-anaesthetic effects of etomidate.

Adrenal Cortex↗
PubMed1993

Etomidate anesthesia increases seizure duration during ECT. A retrospective study.

We reviewed charts of 28 consecutive depressed psychiatric inpatients who had received electroconvulsive therapy (ECT). As a preliminary investigation, we compared the effects of thiopental and etomidate anesthesia on seizure duration. Etomidate, a nonbarbiturate, has been shown to enhance seizure activity in other contexts. The mean age of our sample was 64 years. Because each patient received both etomidate and thiopental at various sessions during their course of ECT, each patient served as his or her own control. The mean proportion of etomidate sessions per patient was 54%. Mean seizure durations were significantly longer (p < 0.001) for the etomidate sessions as compared with the thiopental sessions. In contrast to some prior reports we found that the use of etomidate anesthesia in our sample of 28 consecutive inpatients enhanced seizure duration in ECT. Although controversial, some have advocated that longer seizure times will enhance effectiveness of ECT. We could not compare the anesthetic agents' clinical efficacy in relieving depression due to the retrospective nature of our study.

Adult↗
PubMedDate not supplied

The effect of etomidate on airway management practices of an air medical transport service.

OBJECTIVE: The authors studied the effect of introducing etomidate on the airway management practices of their air transport crew and specifically considered the need for paralytic agents during rapid-sequence intubation. METHODS: A prospective observational review of the transport records for all patients aged greater than 10 years who required intubation transported by the air medical crew before (PRE) and after (POST) the introduction of etomidate into the authors' rapid-sequence induction protocol was conducted. Data were collected, including the method of intubation, indications for intubation, and complications from the procedure. The following outcomes were measured: the method used for intubation (nasotracheal or orotracheal), oral intubation success rate, number of attempts for oral intubation, need for paralytic agents, and complications with the procedure. RESULTS: Comparing the PRE and POST periods, nasotracheal intubation was performed in 27 of 70 (38.6%) versus 33 of 71 (46.4%; p=0.237997). The overall success rate for intubation in the PRE period was 67 of 70 (95.7%), with 95.3% of orotracheal intubations being successful. In the POST period, the overall success rate was 65 of 71 (91.5%), with 94.7% of orotracheal intubations being successful. Complication rates were similar between the groups. Etomidate reduced the use of paralytic agents from 46 of 62 (74.6%) of patients receiving midazolam to 10 of 22 (45.5%) intubated with etomidate (p=0.02). CONCLUSIONS: Etomidate did not appear to have an impact on the selection of intubation methods by the air medical transport crew. Etomidate significantly reduced the need for administration of paralytic agents used in an RSI.

Adult↗
PubMed1989

[Hormonal changes induced by etomidate in children during the first 24 postoperative hours].

The hormonal effects of an etomidate infusion were assessed postoperatively in children undergoing hypospadias or clubfoot repair. The study was carried out in 12 children, aged between 9 and 70 months, randomly assigned to two equal groups. The anaesthetic protocol was identical for all the children, consisting in a light general anaesthesia (halothane induction, intubation after 60 to 80 micrograms.kg-1 vecuronium) combined with lumbar epidural anaesthesia (initial dose of 0.75 ml.kg-1 bupivacaine with adrenaline, with repeat injections of half the previous dose when there was a change in the haemodynamic parameters suggesting inadequate analgesia). Anaesthetic maintenance was different in both groups: 1 to 1.5 vol% enflurane in a nitrous oxide-oxygen mixture (1/1 v/v) in the control group, and 16.8 +/- 3.0 mg.kg-1.min-1 etomidate infusion in the etomidate group. Venous blood samples were collected after induction of anesthesia (before starting the epidural anaesthesia and the etomidate infusion), at the end of surgery (H0), at the 3rd (H3), 6th (H6), 12th (H12) and 24th h (H24) following surgery. The following hormonal blood concentrations were measured: cortisol, 11 beta-desoxycortisol, aldosterone, 11 beta-desoxycorticosterone, dehydroepiandrosterone (DHA) and DHA sulphate (DHA-S). In the control group, cortisol and DHA-S concentrations decreased significantly at H0, aldosterone levels also being significantly lower at H24. In the etomidate group, cortisol concentrations remained significantly lower at H0, H3 and H6; aldosterone concentrations were also significantly lower than control values throughout the study period. There was an important prolonged rise in the concentrations of their precursors. DHA and DHA-S concentrations did not change in the etomidate group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed2000

Awareness during laryngoscopy and intubation: quantitating incidence following induction of balanced anesthesia with etomidate and cisatracurium as detected with the isolated forearm technique.

STUDY OBJECTIVE: To measure the incidence of awareness during induction of anesthesia with etomidate and fentanyl, and to model its frequency as a function of dose of etomidate. DESIGN: Prospective cohort study. SETTING: Anesthesia department of a university hospital. PATIENTS: 30 ASA physical status I, II, and III patients undergoing elective general surgery. INTERVENTIONS: Patients were assigned to one of three groups of etomidate (0.2 mg/kg, 0.3 mg/kg, 0.4 mg/kg) and received fentanyl (2 microg/kg) and 2 x ED(95) of cisatracurium (0.1 mg/kg). Neuromuscular block was monitored with a peripheral nerve stimulator. Intubation was performed after maximum T(1)-depression. To identify awareness, the isolated forearm technique (IFT) was used. The IFT was performed by prompting the patient every 20 seconds. Only a verified response was considered a positive IFT response. Anesthesia was maintained with isoflurane in oxygen/air and fentanyl. MEASUREMENTS AND MAIN RESULTS: Maximum neuromuscular block occurred after 352 +/- 96 seconds and intubation was performed 424 +/- 86 seconds after loss of consciousness (LOC). Awareness was dose dependent: 80% of patients receiving 0.2 mg/kg etomidate, 70% of patients receiving 0.3 mg/kg etomidate, and 20% of patients receiving 0.4 mg/kg etomidate had a positive IFT response. Awareness occurred in one patient 3 minutes after LOC, in 65% during laryngoscopy, and in 30% within the following 120 seconds. One patient had explicit recall without finding awareness unpleasant. Hemodynamic parameters did not differ between patients with a positive or a negative IFT response. CONCLUSIONS: The incidence of awareness during bolus induction can be modeled as dose dependent. However, when combining a short-acting induction drug and a delayed-onset neuromuscular blocker, the continuous infusion of the hypnotic drug may prevent awareness during induction.

Adult↗
PubMed2000

Effects of etomidate on free intracellular amino acid concentrations in polymorphonuclear leucocytes in vitro.

BACKGROUND: Previous studies have shown the inhibitory effects of etomidate on polymorphonuclear leucocyte (PMN) function. No reports exist, however, regarding free intracellular amino acid metabolism, although physiological cell metabolism and basic cell functions rely upon a balanced intracellular amino acid content and the cell membrane-mediated separation of cellular amino acids from the extracellular plasma amino acid pool. Thus, in the current study, we evaluated the effects of etomidate on free intracellular amino acid metabolism in PMN. METHODS: With ethics committee approval, blood was withdrawn from 35 healthy volunteers and incubated (1 h) either with 0 microg/ml, 0.0156 microg/ml, 0.0625 microg/ml or 0.5 microg/ml of etomidate as well as with its additives (propylene glycol and Lipofundin MCT 10%). The PMN were separated using standardized Percoll-gradient and centrifugation procedure before deep-freezing and lyophilization techniques were employed. All PMN samples were dissolved in methanol/H2O, and the concentrations of free intracellular amino acids were monitored using both novel advanced PMN-separation and high-performance liquid chromatography techniques. RESULTS: Etomidate influenced important free amino acid profiles in PMN in a dose-dependent manner, indicating complex changes of cellular amino acid turnover. Neither propylene glycol nor Lipofundin MCT 10% changed free amino acid concentrations in PMN. CONCLUSIONS: For the first time, the effects of etomidate on free intracellular amino acid metabolism in PMN have been investigated. Our results draw attention to the biochemical pathways which may be involved in etomidate-induced alterations in PMN function and cellular immunocompetence.

Adult↗
PubMed1978

Cerebral blood flow and metabolism during etomidate anaesthesia in man.

The effects of etomidate on regional cerebral blood flow (rc.b.f.) and cerebral metabolic rate for oxygen (CMRo2) were studied in seven patients undergoing diagnostic carotid angiography. Following determination of baseline rc.b.f. while awake, the patients were anaesthetized with a single dose of etomidate 15 mg. Thereafter, an infusion of etomidate (2 or 3 mg min-1) was administered. Etomidate decreased both rc.b.f.10 (mean decrease 34%) and CMRo2 (mean decrease 45%). It was concluded that etomidate is a potent cerebral metabolic depressant. Furthermore, the cerebrovascular reactivity to carbon dioxide was maintained under etomidate anaesthesia.

Adult↗
PubMed1985

Effect of etomidate on the auditory evoked response in man.

The effect of etomidate on the auditory evoked response was examined in a double-blind study carried out before the start of surgery. Fourteen patients were anaesthetized with 70% nitrous oxide and oxygen after induction with thiopentone. Ventilation was controlled. Seven of the patients received a continuous infusion of etomidate, increasing in five equal steps from 0.01 mg kg-1 min-1 to 0.05 mg kg-1 min-1 over a period of 50 min. The other seven received similarly an equivalent volume of saline. The patients given etomidate were easily distinguishable from those given saline, solely on the basis of changes in the early cortical peaks Pa and Nb. In the etomidate group the latencies of these peaks increased and their amplitudes decreased. These changes were linearly related to serum etomidate concentration. There was no effect of etomidate on the brainstem response.

Adolescent↗
PubMed1988

Vecuronium induced bradycardia following induction of anaesthesia with etomidate or thiopentone, with or without fentanyl.

To define the role of vecuronium in the occurrence of bradyarrhythmia, haemodynamic changes after the induction of anaesthesia were studied in 96 patients undergoing coronary artery bypass grafting. Patients were assigned to one of six groups according to different combinations of induction agents (etomidate 0.3 mg kg-1 or thiopentone 3 mg kg-1, with fentanyl 0.003 mg kg-1; etomidate 0.4-0.5 mg kg-1 or thiopentone 4-6 mg kg-1, without fentanyl) and neuromuscular blocking drugs (vecuronium 0.112 mg kg-1, pancuronium 0.112 mg kg-1 or suxamethonium 1 mg kg-1). Anaesthesia was maintained with enflurane and nitrous oxide in oxygen. After initial diverse changes, heart rate decreased in all groups. Thirty minutes after intubation, the reduction of heart rate showed statistically significant differences between the different combinations of drugs: fentanyl-etomidate-vecuronium (group I) (the largest reduction) greater than etomidate-vecuronium (II) = fentanyl-thiopentone-vecuronium (IV) greater than thiopentone-vecuronium (V) = fentanyl-thiopentone-suxamethonium (VI) = fentanyl-etomidate-pancuronium (III). Five patients in group I, two in group IV and one each in groups II and V had a heart rate slower than 45 beat min-1, whereas a similar value was never seen in groups III and VI. These results indicate that vecuronium has a bradycardic effect. This effect is more pronounced in association with etomidate than in association with thiopentone, and is augmented by the addition of fentanyl.

Adult↗
PubMed1993

Effects of etomidate on the adrenocortical and metabolic adaptation of the neonate.

The effects of etomidate on corticosteroid synthesis were compared with those of methohexitone. We studied 40 neonates, 22 delivered by elective and 18 by emergency Caesarean section. Apgar scores, blood sugar and plasma concentrations of cortisol and etomidate were evaluated at birth and 2 and 6 h postpartum. There was no difference in Apgar scores attributable to the induction agent. The median cortisol concentrations in cord blood were small (136 nmol litre-1; range 47-478 nmol litre-1, and 259 nmol litre-1; range 58-1504 nmol litre-1 after elective and emergency sections, respectively). During the study, cortisol concentrations increased in the infants in the methohexitone groups and decreased in those in the etomidate groups; this effect was most evident 2 h after delivery (methohexitone groups 245 nmol litre-1, range 70-959 nmol litre-1; etomidate groups 121 nmol litre-1, range 56-320 nmol litre-1). There was no difference at 6 h postpartum (methohexitone groups 183 nmol litre-1, range 25-756 nmol litre-1; etomidate groups 190 nmol litre-1, range 33-628 nmol litre-1). The concentration changes during the study period differed significantly (P < 0.005) with respect to the induction agent. Blood glucose concentrations were small (mean (SD) in all 40 neonates 2 h postpartum was 2.64 (0.77) mmol litre-1), and did not differ between the groups. There were 17 cases of moderate to severe hypoglycaemia (blood glucose concentrations less than 2.5 mmol litre-1): nine in the etomidate group and eight in the methohexitone group.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Obstetrical↗
PubMed1994

Effects of etomidate on whole-cell and single L-type calcium channel currents in guineapig isolated ventricular myocytes.

We have investigated the effects of etomidate 4.4 mumol litre-1, 1.0 mg litre-1 and 27.4 mumol litre-1, 6.25 mg litre-1 on whole-cell and single L-type calcium channel currents in myocytes from guineapig ventricles. For whole-cell recordings, the cells were voltage-clamped and step depolarizations were applied from holding potential of -40 mV to various potentials to elicit L-type calcium currents. Peak calcium currents were decreased significantly by both low and high concentrations of etomidate. Ethanol in the same concentration with the highest etomidate solution (1.1 mmol litre-1) had no significant effect on calcium currents. When single calcium channel activity was investigated, the high concentration of etomidate significantly decreased the open probability of the channel with little or no effect on channel conductance. Mean closed time was increased significantly, caused apparently by prolongation of the slower of two exponential components fitted to histograms of the closed times. The mean open time was virtually unaffected. The low concentration of etomidate did not significantly affect single channel kinetics. These results showed that etomidate decreased L-type calcium current by altering the kinetics of the channel to favour the closed state without any significant change in conductance. However, compared with other anaesthetics which were investigated previously in our laboratory, the overall effect on calcium current appeared to be small.

Animals↗