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British Journal of Anaesthesia, 1985, Vol. 57, No. 2 156-159
© 1985 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

EFFECT OF INDUCTION OF ANAESTHESIA WITH ETOMIDATE ON CORTICOSTEROID SYNTHESIS IN MAN

D. J. R. DUTHIE, M.D., CH.B., F.F.A.R.C.S., R. FRASER, M.SC., PH.D., F.R.S.E. and W. S. NIMMO, M.D., F.R.C.P., F.F.A.R.C.S.*

Department of Anaesthetics, Western Infirmary Glasgow G11 6NT
Medical Research Council Blood Pressure Unit, Western Infirmary Glasgow G11 6NT
University Department of Anaesthesia, Western Infirmary Glasgow G11 6NT

The effects of a single bolus dose of etomidate 0.3 mg kg– or thiopentone 5 mg kg– on the synthesis of corticosteroid hormones and adrenocorticotrophic hormone (ACTH), were compared for 24 h in 12 patients, undergoing minor surgery under general anaesthesia. Following opioid premedication i.m. and general anaesthesia, plasma cortisoi concentrations decreased transiently within the first hour of anaesthesia in all 12 patients. The six patients who received etomidate had statistically higher plasma 11-deoxycorticosterone concentrations at 4 and 24 h than those who had received thiopentone (P < 0.01). Throughout the study, no difference in plasma cortisoi, corticosterone or ACTH concentrations were found between the two groups. We have demonstrated a biochemical effect of a single bolus dose of etomidate consistent with incomplete inhibition of adrenocortical mitochondrial 11 ß-hydroxylase activity, but no clinically significant adrenocortical suppression.

*Present address: Department of Anaesthesia, Sheffield University Medical School, Beech Hill Road, Sheffield S10 2RX.


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