Etomidate (Amidate) Analgesia/Sedation

Question 1

Classification:

Answer 1

• Hypnotic
• Anesthesia induction agent

Question 2

Action:

Answer 2

• Exact mechanism is unknown, etomidate appears to have GABA like effects

Question 3

Indications:

Answer 3

• Induction for RSI and pharmacologic assisted intubation
• Induction of anesthesia

Question 4

Adverse Effects:

Answer 4

• Hypotension
• Respiratory depression
• Pain at the site of injection
• Temporary involuntary muscle movements
• Frequent nausea/vomiting on emergence
• Adrenal insufficiency
• Hyperventilation
• Hypoventilation
• Apnea of short duration
• Hiccups
• Laryngospasm
• Snoring
• Tachypnea
• HTN
• Cardiac arrhythmias

Question 5

Contraindications:

Answer 5

• Known sensitivity
• Use in pregnancy only if potential benefits justify potential risk of the fetus
• Do not use during labor and avoid in nursing mothers

Question 6

Dosage (Adult):

Answer 6

• 0.2 to 0.6 mg/kg slow IV, IO (Over 30-60 seconds); 0.3 mg/kg is used in many protocols/references
• Typical adult intubating dose of etomidate is 20 mg slow IV
• Consider less in older adults or Pts w/ cardiac conditions

Question 7

Dosage (Pediatric)
Older than 10 years:

Answer 7

• Same as adult dosing

Question 8

Dosage (Pediatric)
Younger than 10 years:

Answer 8

• Safety has not been established

Question 9

Special Considerations:

Answer 9

• Etomidate is used to prepare a Pt for orotracheal intubation. Both personnel and equipment must be present to manage Pt’s airway before administration