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At least 19 recordsLinked to original sources

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↗

PubMed1978

Effects of etomidate given in repeated doses.

Fifty fit, female patients were given four consecutive intravenous doses of etomidate 10 mg, so as to maintain sleep, after establishment of epidural block for postpartum sterilization. A matched group was given four doses of thiopentone 125 mg. Cumulative hypnotic effect, as judged by increasing sleep duration with second and subsequent doses, was much less with etomidate than with thiopentone. Etomidate did not depress blood pressure, whereas it fell progressively with successive doses of thiopentone. Injection pain was reported in 68% of patients receiving etomidate, and this tended to increase with successive doses; 12% also showed local inflammation at the injection site. Tremor, due to etomidate, was common, but did not increase with successive doses. Feelings of sleepiness, lasting several hours after waking, were more common after thiopentone than after etomidate.

Anesthesia, Epidural↗

PubMed1976

[Study of a new anesthetic agent: Etomidate (R 26490). Unusual electroencephalic aspects].

Etomidate or R 26490 is a new hypnotic agent produced by JANSSEN and al. in 1971. The first human experimentation was performed in 1972. The authors used Etomidate for 300 anaesthetics given for neuroradiological investigations. Two protocols were used for study: 25 anaesthetics were given with Etomidate as sole anaesthetic to outline its specific properties; 275 angiographies were performed with a combination of Etomidate and fentany1. In protocol no 1, the mean consumption was for 1,85 mg/kg/h, in protocol no2, the mean consumption was of 0,9 mg/kg/h. Pharmacological study of this drug defines it as a short acting hypnotic agent of low toxicity. Clinical observation shows cardiovascular and respiratory stability. However, frequent myoclonias were noted, when Etomidate was given as a sole anaesthetic. EEG recording and evoked response encephalography helped to outline some effects of Etomidate on central nervous system.

Adolescent↗

PubMed1977

[Study of a new anesthetic agent: etomidate (R 26490). Electroencephalographic aspects].

Etomidate or R 26490 is a new hypnotic agent produced by JANSSEN and al. in 1971. The first human experimentation was performed in 1972. The authors used Etomidate for 300 anaesthetics given for neuroradiological investigations. Two protocols were used for study: 25 anaesthetics were given with Etomidate as sole anaesthetic to outline its specific properties; 275 angiographies were performed with a combination of Etomidate and fentanyl. In protocol no. 1, the mean consumption was for 1,85 mg/kg/h, in protocol no. 2, the mean consumption was of 0,9 mg/kg/h. Pharmacological study of this drug defines it as a short acting hypnotic agent of low toxicity. Clinical observation shows cardiovascular and respiratory stability. However, frequent myoclonias were noted, when Etomidate was given as a sole anaesthetic. EEG recording and evoked response encephalography helped to outline some effects of Etomidate on central nervous system.

Adolescent↗

PubMed1978

[The effect of etomidate on CSFP (author's transl)].

The effect of etomidate on cerebro-spinal fluid pressure (CSFP) was investigated in 25 patients. Mean arterial blood pressure (MAP), heart rate (BPM) and blood gases were measured additionally. Cerebral perfusion pressure (CPP) was calculated from the difference MAP minus CSFP. Etomidate lowered CSFP (p less than 0,01 paired Student t-test). Ketamine-induced increase of CSFP (p less than 0,01) was normalized by etomidate. Premedication with etomidate delayed ketamine-induced increase of CSFP, which dropped to normal after a second dose of etomidate. The effect in reducing CSFP of etomidate was seen despite elevation of pCO2(p less than 0,01) in all patients breathing spontaneously.

Adult↗

PubMed1977

Effects of althesin, etomidate and fentanyl on haemodynamics and myocardial oxygen consumption in man.

The acute effects of althesin, etomidate and fentanyl upon haemodynamics, myocardial contractility and oxygen comsumption of the heart were studied in healthy premedicated patients (n = 15) lightly anaesthetized with N2O-O2 (ratio 2:1), 0.3 volumes per cent of halothane and isoflurane respectively. All individuals were ventilated at a normal level. The patients (n = 9) in the halothane group received etomidate 0.3 mg/kg and 20 minutes later althesin 0.075 ml/kg intravenously. In a second group of 6 patients on isoflurane fentanyl 0.01 mg/kg was given. Etomidate did not affect the cardiovascular system significantly. While the decrease in blood pressure after althesin (24 per cent) was the result of a reduction in total peripheral resistance (32 per cent), hypotension associated with fentanyl (23 per cent) was caused by diminished output due to bradycardia (18 per cent). Load data,heart rate, and maximum dp/dt indicated moderate negative inotropic properties only of althesin. Using the complex haemodynamic parameter developed by Bretschneider the myocardial oxygen consumption was calculated. The energy demand of the heart decreased with etomidate, althesin and fentanyl by 14 per cent, 16 per cent and 32 per cent respectively. It is concluded that the risk of cardiovascular depression at induction in patients with impaired myocardial performance and coronary insufficiency can be minimized with etomidate and/or fentanyl.

Adult↗

PubMed1978

Electroencephalographic study of the short-acting hypnotics etomidate and methohexital in dogs.

Beagles, implanted with cortical and subcortical electrodes, were given etomidate i.v. (1 mg/kg) over a period of 10 sec. The effects on the EEG were compared with those obtained with 7 mg/kg of methohexital. Both compounds induced hypnosis for a duration of approximately 8 min. The EEGs showed a remarkable similarity. Visual inspection of the records as well as power spectrum analysis revealed a sustained theta-activity with underlying fast activity. The configuration of the waves was rather sharp. The power obtained after etomidate was, however, 2 to 3 times that obtained after methohexital. When the animals awoke from etomidate-induced hypnosis slow waves appeared and were followed by alpha-activity, whereas after methohexital-hypnosis beta-activity predominated. Etomidate slightly increased heart rate, but respiratory depression was not observed. Methohexital caused pronounced tachycardia and apnoea. In 3 out of 6 dogs methohexital caused myoclonus of the hind legs upon awakening from anaesthesia. Etomidate induced myoclonus in one dog during hypnosis.

Animals↗

PubMed1979

Comparison of etomidate in combination with fentanyl or diazepam, with thiopentone as an induction agent for general anaesthesia.

In 104 premedicated patients undergoing general surgery, anaesthesia was induced either with etomidate 0.3 mg kg-1 preceded by fentanyl 1.25 or 2.5 microgram kg-1 i.v.or diazepam 0.0625 or 0.125 mg kg-1 i.v., or with thiopentone preceded by fentanyl 1.25 microgram kg-1 i.v. Despite the use of fentanyl or diazepam, the frequency of pain on injection in patients receiving etomidate was between 32% and 53%, being rated as severe in 5-20% of patients. No pain was experienced by patients receiving thiopentone. The frequency of involuntary movement was 15-35% with etomidate and 15% with thiopentone. The frequency of both pain and involuntary muscle movements was least when fentanyl 2.5 microgram kg-1 preceded the administration of etomidate. There was no significant relationship between the pain and muscle movement; three of 10 patients given etomidate into a central vein had such movements.

Adult↗

PubMed1978

[Effect of etomidate on cerebral blood flow and oxygen metabolism in man].

The effects of Etomidate on cerebral blood flow (C.B.F.) and cerebral oxygen consumption (C.02 C.) were studied in 13 patients in a neuroradiology department. Induction of anaesthesia was ensured using a standard dose of 15 mg of Etomidate, followed by a constant rate infusion (2.8 mg/kg/hour). Seven subjects were considered to be normal whilst six were suffering from tumour pathology. Under the influence of Etomidate, C.B.F. in the normal subjects decreased by 34 p. 100 and C.02 C. by 46.7 p. 100. The relationship between C.B.F. and arterial PC01 was studied under the influence of Etomidate: cerebral vasoactivity to C02 was maintained. A special study was made of focal changes in flow in patients with tumour pathology. Under the influence of Etomidate, there were zones of adaptation of flow, indicative of vasoparalysis situated opposite the tumour.

Anesthesia, General↗

PubMed1978

[Constant flow anesthesia using a combination of etomidate and fentanyl].

In 35 orthopaedic surgery patients (33 adults and 2 children), anaesthesia was obtained using an association of etomidate and fentanyl. Induction was obtained by injection from a syringe of a mixture of etomidate and fentanyl in an average dose of 21 mg for etomidate and 0,08 mg for fentanyl. Anaesthesia was maintained by constant dose of etomidate was 1.29 mg/kg/h and 4.96 microgram/kg/h for fentanyl. The mixture used for both induction and maintenance contained 1.3 mg of etomidate and 5 mg of fentanyl per ml. The results, value, indications and contraindications of this technique are described.

Adolescent↗

PubMed1978

Multinational evaluation of etomidate for anesthesia induction. Conclusions and consequences.

An overall analysis was made of 4763 case report forms from 45 anesthesiologists who used etomidate (Hypnomidate) routinely as an induction hypnotic in a total of 4127 surgical cases or compared it to thiopental in a series of controlled studies (325 on etomidate, 311 on thiopental). Premedication was standardized only in the controlled studies, and there were no restrictions on the use of anesthetic agents or techniques. Etomidate proved to be a safe and effective induction hypnotic. Sleep was deep and long enough to allow the normal induction and maintenance procedures. Blood pressure and heart rate remained remarkably stable in the 3 study groups. The incidence of respiratory depression was higher for thiopental; anesthesiologists' acceptance of etomidate was, however, reduced by the occurrence of venous pain during injection and of associated involuntary muscle movements. It is expected that these adverse effects will be largely eliminated by using the recently introduced new formulation of etomidate shortly after fentanyl.

Adolescent↗

PubMed1978

Venous pain and involuntary muscular movements during and after administration of etomidate. A comparison of two different formulations.

Anaesthesia was induced in 209 patients with etomidate, using either the two vidal formulation, i.e. a solution of 30 mg etomidate sulphate in 20 ml phosphate buffered solution or the new formulation i.e. 5ml ampoules containing 2% etomidate base in polyethylene glycol 1000 (PEG 1000), a ready-for-use solution. Amongst patients who received the two vial formulation of etomidate (n = 105), 26 reported pain on injection as compared with six patients who received etomidate in PEG 1000 (n = 104). In the former group, involuntary muscle movements were reported in 12 patients, three of them being disturbing. In the latter group slight involuntary muscle movements occurred in 15 patients, but were never disturbing.

Adolescent↗

PubMed1978

[Comparative investigations on the influence of etomidate, thiopentone and methohexitone on the intracranial pressure of the patient (author's transl)].

Intracranial pressure was measured under the influence of the new hypnotic etomidate (Dosage: 0.15 to 0.30 mg/kg b.w.). For comparison thiopentone (Trapanal: 3 to 4.5 mg/kg) and methohexitone (Brevimytal: 1 to 1.5 mg/kg) were given. The investigations were performed on 28 neurosurgical patients, who thereafter underwent surgery. The patients already had a closed or open ventricular catheter by means of which intracranial pressure was continuously measured. Etomidate lowered intracranial pressure. This happened during induction of anaesthesia and later during neuroleptanalgesia when etomidate was again injected. The pressure fall after etomidate was similar to that seen after thiopentone. It was at the time of induction 5 and later on 3mm Hg. Methohexitone showed a somewhat smaller effect. The cerebral perfusion pressure was calculated. When etomidate was given during the course of a neuroleptanalgesia the cerebral perfusion pressure merely decreased slightly (-7 per cent). Perfusion pressure remained stable after thiopentone and methohexitone.

Adolescent↗

PubMed1978

[Effects of etomidate and thiopentone on the primarily elevated intracranial pressure (ICP) (author's transl)].

In 8 patients having primarily an increased ICP, the effects of etomidate on ICP, arterial pressure and cerebral perfusion pressure (CPP) were studied by comparison with thiopentone. The patients received no premedication or basic anaesthesia and relaxation was obtained using pancuronium bromide. Blood gas analysis was performed at regular intervals to maintain a constant level of the arterial pCO2. Under the conditions of a reduced intracranial compliance and an elevated ICP, thiopentone lowered the arterial pressure considerably in contrast to etomidate. The primarily elevated ICP was reduced by both, etomidate and thiopentone to an extent of 27 per cent for more than 10 min. The considerable decrease of arterial pressure by thiopentone caused marked lowering of CPP during more than 10 min. In the same period etomidate did not influence either arterial pressure or CPP. These results show that for the induction of anaesthesia in neurosurgical patients having a primarily increased ICP etomidate has good properties.

Adolescent↗

PubMed1978

Further experience with etomidate.

We report our further anaesthetic experience with Etomidate in 100 patients. The cardiovascular and respiratory systems were not significantly affected but intraocular pressure was reduced. The occurrence of pain during injection of Etomidate was unaffected by analgesic premedication but was reduced by using a solution buffered to a higher pH and by choosing a big vein for injection. The myoclonic movements often seen with Etomidate anaesthesia were transient and have so far not created any major problem; they were reduced by a slower speed of injection but unaffected by diazepam premedication or pretreatment with low dose of a non-depolarizing muscle relaxant (pancuronium). Etomidate is a satisfactory alternative to thiopentone in situations where depression of the cardiovascular and respiratory systems are undersirable or where barbiturates are otherwise contraindicated and is a usefull addition to the induction agents in our anaesthetic practice.

Adolescent↗

PubMed1977

Effect of etomidate on intra-ocular pressure.

Etomidate, a new short-acting non-barbiturate hypnotic, was administered to 40 patients between the ages of 12 years and 65 years. Intra-ocular pressure was measured before and after etomidate injection using a Schiotz tonometer. A significant reduction of intra-ocular pressure was found to follow etomidate injection in spite of the often associated myoclonic movements. The mechanism of reduction of intra-ocular pressure has not been determined in this study. It is suggested that etomidate will be a useful intravenous induction agent where elevation of intra-ocular pressure is undesirable.

Adolescent↗

PubMed1977

Clinical trial of etomidate. Preliminary observations on a new non-barbiturate induction agent.

This is a preliminary report of our clinical experience with etomidate, a new intravenous non-barbiturate anaesthetic agent. Thirty-two patients undergoing minor surgical procedures were anaesthetized, induction being with etomidate 0.3 mg/kg body weight. Induction was fast and smooth. Twenty-eight per cent of the patients complained of pain at site of injection but the pain disappeared on flushing with water for injection. Following etomidate injection, 37.5 per cent of patients developed myoclonic movements which were usually mild and self-limiting. We were impressed by the relative stability of the cardiovascular and respiratory systems. Etomidate looks promising and further work is in progress on other aspects of this drug.

Anesthesia, Intravenous↗

PubMed1978

An investigation of the centrally and peripherally mediated cardiovascular effects of etomidate in the rabbit.

In the decerebrate rabbit etomidate caused dose-related decreases in mean arterial pressure and preganglionic sympathetic nerve activity. There were no significant alterations in heart rate. Etomidate was found to have no effect on the baroreceptor reflex. In pithed animals the effects of etomidate were of short duration and of a lesser magnitude than in the decerebrate animal. It was concluded that the additional effects in the decerebrate rabbit were a result of depression of central cardiovascular control. It was found that etomidate was largely without effect on the cardiovascular system at normal anaesthetic doses (0.5-1 mg-kg-1). However, larger doses (2-8 mg kg-1) produced marked depression of central cardiovascular control, the myocardium and the peripheral vasculature.

Animals↗