Effects Of Etomidate On Human Adrenocortical Function

Objective To investigate the effects of Etomidate on human adrenocortical function compared with Propofol. Methods Forty ASAⅠ～Ⅱpatients with infertility or ovarian tumor scheduled operation under celioscope were divided into four groups with ten patients of each: propofol group( groupⅠ); etomidate induction group(groupⅡ); etomidate induction and 5μg . kg-1. min-1 maintenance group(groupⅢ); etomidate induction and 10μg . kg-1. min-1 maintenance group(groupⅣ). In every group, SBP, DBP, MAP, HR, ECG, SPO2, PETCO2, BIS were monitored. Blood samples for the measurement of cortisol, aldosterone, and adrenocorticotrophic hormone (ACTH) were collected before induction (H1) and 30 min (H2), 2 h (H3), 24 h (H4) after induction. Results GroupⅠ: Cortisol, aldosterone increased at H2 and H3, while ACTH decreased; Cortisol, aldosterone and ACTH nearly recovered to the baseline at H4. GroupⅡ: Cortisol, aldosterone decreased at H2 and H3(P<0.05), while ACTH increased; Cortisol, aldosterone and ACTH nearly recovered to the baseline at H4. GroupⅢ: Cortisol, aldosterone decreased at H2 and H3(P<0.05); Cortisol has recovered to 62.52% of the baseline at H4; ACTH increased at H2(P<0.05) and recovered to the baseline at H4. GroupⅣ: Cortisol, aldosterone decreased at H2 and H3(P<0.05), ACTH increased at H3(P<0.05); Cortisol has recovered to 62.58% of the baseline at H4; aldosterone and ACTH has recover to the baseline at H4. Conclusions Etomidate single dose induction can inhibit adrenocortical function but do not exceed 24 h. Etomidate used in induction and maintenance can suppress adrenocortical function over 24 h, but cortisol is beyond 60% of the baseline at 24 h after induction.