Washington—Anesthesiologists tempted to use etomidate instead of propofol to induce anesthesia in critically ill patients might think twice after considering the results of a retrospective analysis by researchers at Cleveland Clinic. The analysis concluded that noncardiac patients given etomidate were two to three times more likely than those given propofol to die within 30 days.
“Although etomidate is sometimes used for general anesthesia induction in critically ill patients, the drug is known to cause prolonged adrenal impairment by blocking cortisol release,” said Ryu Komatsu, MD, a resident at the Ohio institution. “As we might suspect, worse outcomes have been reported in association with etomidate use in critically ill patients. However, the potential link between etomidate and worsened postoperative outcomes has not been systematically studied in general surgical patients.”