A 34 year old female with Cushing's syndrome is taken for a surgery. Which anaesthetic agent is known to produce adrenocoical suppression?
Etomidate inhibits the enzyme, 11- hydroxylase, which is necessary for the production of coisol, aldosterone, and coicosterone. Even single doses of etomidate can produce adrenocoical suppression lasting 24 hours or more in healthy patients. Etomidate is contraindicated in patients with established or evolving septic shock because of its inhibition of coisol synthesis. Ref: Pharmacology and Physiology in Anesthetic Practice By Robe K. Stoelting, Simon C. Hillier, 2012, Chapter 6; Procedures and Techniques in Intensive Care Medicine, 4e By Richard S Irwin, MD, James M Rippe, M.D., 2007, Page 172.
Thiopentone
Etomidate
Ketamine
Propofol