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

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Abstract
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 ACTH, were compared for 24 h in 12 patients, undergoing minor surgery under general anesthesia. Following opioid premedication i.m. and general anesthesia, plasma cortisol concentrations decreased transiently within the 1st h of anesthesia in all 12 patients. The 6 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). No difference in plasma cortisol, corticosterone or ACTH concentrations were found between the 2 groups. A biochemical effect of a single bolus dose of etomidate consistent with incomplete inhibition of adrenocortical mitochondrial 11 .beta.-hydroxylase activity, but no clinically significant adrenocortical suppression was demonstrated.