Etomidate is not used for long term infusion because?
Ans. is 'a' i.e., Results in adrenal suppression * Etomidate suppresses corticosteroid synthesis in the adrenal cortex by reversibly inhibiting 11 b-hydroxylase, which coverts 11-deoxycortisol to cortisol and by a relative minor effect on 17a - hydroxylase.* There is decreased synthesis of adrenal corticoids with increase in precursors 11-deoxycortisol and 17-hydroxyprogesterone.* ACTH secretion increases due to loss of feedback inhibition.* Using a continuous etomidate infusion for sedation of critically ill trauma patients in intensive care units has been associated with increased mortality due to adrenal suppression.* The mortality of patients exposed to a continuous infusion of etomidate for more than 5 days increased from 25% to 44%, mainly due to infectious causes such as pneumonia.* Vit 'C' supplementation restores cortisol levels to normal after use of etomidate.About other options* It produces little cardiovascular and respiratory depression - Agent of choice for cardiovascular surgeries (bypass, aneurysms, valve surgery). Etomidate is most cardiostable inducing agent. Coronary perfusion pressure is maintained when it is used with fentanyl.* Similar to thiopentone & propofol, etomidate is cerebroprotective - Decreases cerebral blood flow, metabolism, oxygen consumption and ICT.* Superficial thrombophlebitis and pain may occur on IV injection but intraarterial injection is not associated with local or vascular complications.
Results in adrenal suppression
May cause vasospasm
Results in cardiac arrhythmias
May cause increase in ICT
Complications Of Anaesthesia