Etomidate - 7


AVOID longterm IV sedation with etomidate for many hours to days (CONTRAINDICATED)
Longterm infusion is likely to result in inhibition of adrenal steroid synthesis with decreased levels of cortisol and aldosterone:
11-beta-hydroxylase inhibition
RE: "Nuisance" side effects
  • Pain on injection (less with propylene glycol formulation, less with larger volume, pre-med, lidocaine 1-2 min prior) 10-50%
  • Myoclonic movements - variable (10-70%), less after benzodiazepine or narcotic premed or perhaps if injected more slowly
  • hiccuping - variable
  • Nausea and vomiting 30-40% (more with fentanyl; patient's #1 complaint)
  • Thrombophlebitis (more likely with proylene glycol formulation, 23%) (Note: Intra-arterial injection leads to no local or vascular pathology!)

Greg Gordon MD
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