Toward a Better Etomidate

Abstract

More than 45 years after its development, etomidate still sees widespread use as a hypnotic agent for single-dose sedation of critically ill and hemodynamically unstable patients. Potent and prolonged inhibition of cortisol synthesis by etomidate, even following single-dose administration, is controversial and a legitimate concern for clinicians. This article will briefly review etomidate pharmacology. It will also discuss some recent basic science and translational studies that have yielded several novel and clinically promising etomidate analogues designed to circumvent etomidate adrenal suppression.