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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Total I.V. anesthesia was given to 20 patients using an Etomidate continuous infusion to maintain sleep, combined to Fentanyl analgesia, Droperidol, Pancuronium for muscular relaxation and artificial ventilation with an oxygen-air mixture. All these patients were carefully observed during and for several hours after the anesthesia and the results noted. With the Fentanyl dosages used in this technique, peroperative analgesia was frequently insufficient. More Fentanyl would probably be needed with the inherent dangers of prolonged postoperative depression.
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PMID:Total I.V. anesthesia using a continuous etomidate infusion. 54 55

In the decerebrate rabbit etomidate caused dose-related decreases in mean arterial pressure and preganglionic sympathetic nerve activity. There were no significant alterations in heart rate. Etomidate was found to have no effect on the baroreceptor reflex. In pithed animals the effects of etomidate were of short duration and of a lesser magnitude than in the decerebrate animal. It was concluded that the additional effects in the decerebrate rabbit were a result of depression of central cardiovascular control. It was found that etomidate was largely without effect on the cardiovascular system at normal anaesthetic doses (0.5-1 mg-kg-1). However, larger doses (2-8 mg kg-1) produced marked depression of central cardiovascular control, the myocardium and the peripheral vasculature.
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PMID:An investigation of the centrally and peripherally mediated cardiovascular effects of etomidate in the rabbit. 62 92

Beagles, implanted with cortical and subcortical electrodes, were given etomidate i.v. (1 mg/kg) over a period of 10 sec. The effects on the EEG were compared with those obtained with 7 mg/kg of methohexital. Both compounds induced hypnosis for a duration of approximately 8 min. The EEGs showed a remarkable similarity. Visual inspection of the records as well as power spectrum analysis revealed a sustained theta-activity with underlying fast activity. The configuration of the waves was rather sharp. The power obtained after etomidate was, however, 2 to 3 times that obtained after methohexital. When the animals awoke from etomidate-induced hypnosis slow waves appeared and were followed by alpha-activity, whereas after methohexital-hypnosis beta-activity predominated. Etomidate slightly increased heart rate, but respiratory depression was not observed. Methohexital caused pronounced tachycardia and apnoea. In 3 out of 6 dogs methohexital caused myoclonus of the hind legs upon awakening from anaesthesia. Etomidate induced myoclonus in one dog during hypnosis.
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PMID:Electroencephalographic study of the short-acting hypnotics etomidate and methohexital in dogs. 63 Nov 87

An overall analysis was made of 4763 case report forms from 45 anesthesiologists who used etomidate (Hypnomidate) routinely as an induction hypnotic in a total of 4127 surgical cases or compared it to thiopental in a series of controlled studies (325 on etomidate, 311 on thiopental). Premedication was standardized only in the controlled studies, and there were no restrictions on the use of anesthetic agents or techniques. Etomidate proved to be a safe and effective induction hypnotic. Sleep was deep and long enough to allow the normal induction and maintenance procedures. Blood pressure and heart rate remained remarkably stable in the 3 study groups. The incidence of respiratory depression was higher for thiopental; anesthesiologists' acceptance of etomidate was, however, reduced by the occurrence of venous pain during injection and of associated involuntary muscle movements. It is expected that these adverse effects will be largely eliminated by using the recently introduced new formulation of etomidate shortly after fentanyl.
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PMID:Multinational evaluation of etomidate for anesthesia induction. Conclusions and consequences. 63 92

We report our further anaesthetic experience with Etomidate in 100 patients. The cardiovascular and respiratory systems were not significantly affected but intraocular pressure was reduced. The occurrence of pain during injection of Etomidate was unaffected by analgesic premedication but was reduced by using a solution buffered to a higher pH and by choosing a big vein for injection. The myoclonic movements often seen with Etomidate anaesthesia were transient and have so far not created any major problem; they were reduced by a slower speed of injection but unaffected by diazepam premedication or pretreatment with low dose of a non-depolarizing muscle relaxant (pancuronium). Etomidate is a satisfactory alternative to thiopentone in situations where depression of the cardiovascular and respiratory systems are undersirable or where barbiturates are otherwise contraindicated and is a usefull addition to the induction agents in our anaesthetic practice.
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PMID:Further experience with etomidate. 63 25

A comparative study between Etomidate and Thiopentone was carried out on 100 healthy female patients scheduled for post-partum abdominal sterilization under epidural analgesia. Our results show Etomidate to be a safe and effective induction agent, comparable to Thiopentone in having a rapid onset of action and rapid recovery time. The pulse rates and blood pressures remained relatively stable during the use of Etomidate. However, there was a high incidence of transient respiratory upsets while causing less respiratory depression than Thiopentone. The objectionable features of Etomidate are high incidence of pain on injection and involuntary muscular activity, which account for the low anaesthetist acceptance rate.
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PMID:Clinical evaluation of etomidate as an induction agent. 66 89

The effect of Etomidate on central sympathetic activity, respiration and circulation were studied in animals at rest and under asphyctic conditions. The doses used were 0.15, 0.3 and 0.6 milligrams/kilogram bodyweight. Injection of the drug into animals at rest caused excitation lasting for about 10 seconds and then lowering of sympathetic activity by about 15-30 per cent. With doses of 0.6 mg the depression lasted for about 15 minutes. Central stimulation by asphyxia often a more pronounced dose-dependent depression of sympathetic activity by about 15-40% of the original level was observed. Activity of the phrenic nerve was affected only with doses of 0.6 mg; the reduction by about 30% lasted for up to 15 min. Injection of 0.6 mg was followed within one minute by a short-lasting fall in blood pressure by about 10%. The heart rate remained unchanged at rest but during asphyctic conditions the heart rate was less slowed down than would normally occur with vagal stimulation. Etomidate apparently also depressed the vagal centres. Similarities and differences in action between Etomidate and propanidid are discussed.
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PMID:[An experimental study of the effect of etomidate on central sympathetic activity, respiration and circulation (author's transl)]. 74 Jun 30

The acute effects of althesin, etomidate and fentanyl upon haemodynamics, myocardial contractility and oxygen comsumption of the heart were studied in healthy premedicated patients (n = 15) lightly anaesthetized with N2O-O2 (ratio 2:1), 0.3 volumes per cent of halothane and isoflurane respectively. All individuals were ventilated at a normal level. The patients (n = 9) in the halothane group received etomidate 0.3 mg/kg and 20 minutes later althesin 0.075 ml/kg intravenously. In a second group of 6 patients on isoflurane fentanyl 0.01 mg/kg was given. Etomidate did not affect the cardiovascular system significantly. While the decrease in blood pressure after althesin (24 per cent) was the result of a reduction in total peripheral resistance (32 per cent), hypotension associated with fentanyl (23 per cent) was caused by diminished output due to bradycardia (18 per cent). Load data,heart rate, and maximum dp/dt indicated moderate negative inotropic properties only of althesin. Using the complex haemodynamic parameter developed by Bretschneider the myocardial oxygen consumption was calculated. The energy demand of the heart decreased with etomidate, althesin and fentanyl by 14 per cent, 16 per cent and 32 per cent respectively. It is concluded that the risk of cardiovascular depression at induction in patients with impaired myocardial performance and coronary insufficiency can be minimized with etomidate and/or fentanyl.
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PMID:Effects of althesin, etomidate and fentanyl on haemodynamics and myocardial oxygen consumption in man. 83 81

We have studied the effects of etomidate on preganglionic cervical sympathetic activity, arterial pressure, and pulse rate. Normal and baroreceptor-denervated animals were studied. On the basis of findings it is concluded that etomidate exerts a minimal direct depressant action on the cardiovascular system. A profound depression of sympathetic tone was observed in spite of unaffected arterial pressure. Etomidate was also shown to possess a mild vagolytic action.
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PMID:The effects of etomidate on arterial pressure, pulse rate and preganglionic sympathetic activity in cats. 90 95

Etomidate and methohexital were administered for induction of anesthesia in 45 patients who had to undergo open heart surgery. The anesthesia technique was otherwise standardised. Measurements of blood pressure and heart rate were obtained during a period of ten minutes after injection of the induction agent, and in a selected group of 16 patients cardiac index and stroke volume index were obtained by impedance cardiography. In the group of 45 patients, blood pressure one minute after induction was unchanged with Etomidate, but decreased (-6%) with methohexital. During intubation, important variations of systolic blood pressure occurred, specially with Etomidate (+ 36%) and less with methohexital (+ 21%). Heart rate increased in both groups during intubation (+ 41%) and returned towards starting value after ten minutes. In the group of 16 patients, cardiac index varied with Etomidate, decreasing during intubation (- 21%), increasing to + 32% and then returning to starting value afterwards. Heart rate increased with intubation (+ 39%) and was still somewhat elevated at ten minutes. Stroke volume index decreased with intubation (- 36%) and was still lower than the initial value at ten minutes (- 14%). With methohexital, cardiac index variations were less pronounced (+ 11%). Cardiac index was lower than the initial value at ten minutes (- 14%). Stroke volume index decreased with intubation (- 36%) and was still lower than the initial value at ten minutes (- 14%). This was compensated by an increase in heart rate. These measurements made during induction reflect the complex interaction of drug administration and technical manipulations. Blood pressure lowering one minute after the injection of methohexital can be ascribed to vasodilatation and myocardial depression. The important blood pressure and cardiac index variations observed with Etomidate are probably due to the short action and the lack of analgesic properties of this agent.
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PMID:Clinical use of etomidate. 101 16


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