ETOMIDATE

• Induction of anaesthesia

Given as a slow IV injection i.e. 10 ml over 30–60 seconds

• May be diluted with normal saline or dextrose infusion

• Hypersensitivity

• Myoclonus, dyskinesia
• Vein pain, hypotension
• Nausea, vomiting
• Apnoea, hyperventilation, stridor (high-pitched breaths)
• Rash

• Adrenaline neurone blockers (enhanced hypotensive effect)
• Alpha blockers (enhanced hypotensive effect)
• Verapamil (enhanced hypotensive effect)
• Antipsychotics (enhanced hypotensive effect)

• Do not operate dangerous machinery or drive vehicles during the first 24 hours after administration

• Can be used

• Can be used

• Reduce dose in liver cirrhosis, in patients receiving neuroleptic, opiate or sedative agents
• Resuscitation equipment should be available
• Etomidate may depress neonatal respiration if used during delivery
• It is not compatible with Ringer’s lactate infusion
• Do not mix with pancuronium
• Extraneous muscle movements can be minimised by an opioid analgesic or a short-acting benzodiazepine given just before induction
• Pain on injection can be reduced by injecting into a larger vein or by giving an opioid analgesic just before induction
• Etomidate suppresses adrenocortical function, particularly during continuous administration, and it should not be used for maintenance of anaesthesia. Use with caution in patients with underlying adrenal insufficiency for example, those with sepsis