Etomidate and its derivatives: time to say goodbye?

IF 9.1 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia Pub Date : 2025-01-01 DOI:10.1016/j.bja.2024.09.011

J. Robert Sneyd , Beatrijs I. Valk

引用次数: 0

Abstract

Etomidate, an intravenous hypnotic used for anaesthesia and critical care, is known for its undesirable side effects, including pain on injection, myoclonus, and adrenocortical depression. Despite its continued clinical use because of its haemodynamic stability and rapid onset and offset of effect, alternatives like propofol, ketamine, and remimazolam offer fewer drawbacks. Recent efforts to improve etomidate through chemical modifications, such as methoxyethyl etomidate hydrochloride (ET-26), have shown limited success, with persistent issues like involuntary muscle movements and adrenocortical suppression. We suggest that it might be time to move on from etomidate and focus on developing new anaesthetic agents.

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依托咪酯及其衍生物：是时候说再见了？

依托咪酯是一种用于麻醉和危重症护理的静脉催眠药，其不良副作用包括注射时疼痛、肌痉挛和肾上腺皮质抑制。尽管由于其血流动力学稳定性和快速起效和抵消效应而继续在临床使用，但异丙酚、氯胺酮和雷马唑仑等替代品的缺点较少。最近通过化学修饰改善依托咪酯的努力，如甲氧乙基依托咪酯盐酸盐（ET-26），已经显示出有限的成功，持续的问题，如不随意肌运动和肾上腺皮质抑制。我们建议，也许是时候放弃依托咪酯，专注于开发新的麻醉剂了。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British journal of anaesthesia 医学-麻醉学

CiteScore

13.50

自引率

7.10%

发文量

488

审稿时长

27 days

期刊介绍： The British Journal of Anaesthesia (BJA) is a prestigious publication that covers a wide range of topics in anaesthesia, critical care medicine, pain medicine, and perioperative medicine. It aims to disseminate high-impact original research, spanning fundamental, translational, and clinical sciences, as well as clinical practice, technology, education, and training. Additionally, the journal features review articles, notable case reports, correspondence, and special articles that appeal to a broader audience. The BJA is proudly associated with The Royal College of Anaesthetists, The College of Anaesthesiologists of Ireland, and The Hong Kong College of Anaesthesiologists. This partnership provides members of these esteemed institutions with access to not only the BJA but also its sister publication, BJA Education. It is essential to note that both journals maintain their editorial independence. Overall, the BJA offers a diverse and comprehensive platform for anaesthetists, critical care physicians, pain specialists, and perioperative medicine practitioners to contribute and stay updated with the latest advancements in their respective fields.