JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by GHONEIM, M. M. Articles by YAMADA, T. Search for Related Content PubMed PubMed Citation Articles by GHONEIM, M. M. Articles by YAMADA, T.

Etomidate

A Clinical and Electroencephalographic Comparison with Thiopental

M. M. GHONEIM, MD^*, and T. YAMADA, MD

*Professor, Department of Anesthesia. Assistant Professor, Department of Neurology. University of Iowa College of Medicine, Iowa City, Iowa 52242.

Abstract

Etomidate, a new intravenous anesthetic, was compared with thiopental for induction of anesthesia in 120 patients. Patients were randomly assigned to one of 12 different groups according to premedication, induction agent, and rate of injection. There were 3 types of premedication: atropine (0.5 mg); fentanyl (0.1 mg) with, atropine (0.5 mg); and diazepam (10 mg) with atropine (0.5 mg). The induction agent was either etomidate (0.3 mg/kg) or thiopental (3.5 mg/kg) administered IV during 30 or 60 seconds. Respiratory rate, pulse rate, and blood pressure were measured before induction and every minute afterwards for 3 minutes. Patients were also observed for side effects up to 48 hours postoperatively. The EEG was recorded in 10 patients given etomidate and 5 given thiopental.

Forty-three percent of the patients who received etomidate complained of pain during injection, compared to 1.7 percent with thiopental. Of the patients who received etomidate, 28 percent developed myoclonic movements versus none with thiopental. There was a significant association between pain and movements. Movements were also more frequent with atropine premedication alone than with fentanyl. Thiopental produced a higher incidence of apnea during the 1st and 2nd minutes, and more slowing of the respiratory rate. The main EEG differences between the 2 drugs, in the dosage used, were the lack of beta activity and a considerably longer duration of "deep stage" with etomidate versus the lack of periodic burst suppression pattern with thiopental. Myoclonic movements during etomidate anesthesia were not associated with epileptiform discharges.

This article has been cited by other articles:

				I. Rundshagen, T. Schroder, L. S. Prichep, E. R. John, and W. J. Kox Changes in cortical electrical activity during induction of anaesthesia with thiopental/fentanyl and tracheal intubation: a quantitative electroencephalographic analysis Br. J. Anaesth., January 1, 2004; 92(1): 33 - 38. [Abstract] [Full Text] [PDF]

				M. N. Avramov and P. F. White Etomidate: Its Pharmacologic and Physiologic Effects Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 1997; 1(2): 132 - 141. [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999