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

A new short general anaesthesia for minor gynaecological operations is presented, which is also suitable for out-patients. The patient receives 0.05 mg. Atropin and 10 mg. Diazapam i.m. 30 minutes prior to the operation. Pentazocin in a dosage of 0.75 mg/kg. body weight was injected intravenously. 1 minute later Etomidate in a dosage of 0.3 mg/kg. body weight was injected intravenously. 1/3 of the initial dose of Etomidate was given as necessary at an average of 5 minutes following the initial dose. Through-out the procedure the patients spontaneously breathe room air. As advantages of the method are listed the minimal disturbances of the heart and the circulatory system, the lack of respiratory depression, the lack of specific organ toxicity, the absence of measurable release of histamine, the unlimited frequent repetition possible, the lack of damage to the personnel by anaesthetic gases and the safety and simplicity of the anaesthesia.
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PMID:[Short gynaecological general anaesthesia with pentazocin and etomidate combined with room air (author's transl)]. 677 9

The action of etomidate, a short-acting non-barbiturate hypnotic agent, was studied in three groups of patients. Used alone for induction it did not significantly alter either the pulse rate or the diastolic blood pressure. Systolic blood pressure fell slightly, but became stable after 2 minutes. The pH of the arterial blood was not significantly altered. pO2 and pCO2 showed changes indicative of respiratory depression during induction (group 1). Etomidate combined with fentanyl caused a moderate, significant fall in both diastolic and systolic blood pressure, but did not affect the pulse rate (group 2). In view of its inconsiderable haemodynamic effects etomidate can be regarded as a safe agent for induction. In doses of 10-20 micrograms/kilogramme bodyweight/minute infusions of etomidate (combined with fentanyl and muscle relaxants) provide adequate basal narcosis for most routine surgical operations. It cannot, however, be considered the anaesthetic of choice for major abdominal surgery which requires deep analgesia and full muscular relaxation (group 3).
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PMID:[A clinical study on the use of etomidate for induction and maintenance of anaesthesia (author's transl)]. 678 34

Etomidate (Hypnomidate; Ethnor) in an alcoholic solution was used as the hypnotic component of a technique of total intravenous anaesthesia in an open pilot evaluation in 50 patients undergoing surgery. No anaesthetic gases were used. Despite cardiovascular stability, lack of respiratory depression and a short awakening time, unwanted movements by the patients made total intravenous anaesthesia with this technique unsatisfactory.
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PMID:Hypnosis with etomidate during total intravenous anaesthesia. 700 71

Etomidate was compared with alfathesin for induction and maintenance of anaesthesia in a double-blind fashion in 48 fit patients undergoing minor gynaecological operations as outpatients. The patients were randomized to receive either etomidate 0.3 mg . kg-1 or alfathesin 75 microliters . kg-1 as intravenous induction agents. All patients received fentanyl 1 microgram . kg-1 and breathed 70 per cent nitrous oxide in oxygen. Cardiovascular changes were minimal in both groups and there was less depression of minute volume with etomidate. The incidence of side effects including pain upon injection, involuntary movements, and postoperative nausea and vomiting was higher following etomidate. Recovery was equally rapid in both groups. No adverse reactions were seen. Alfathesin would appear to be preferable to etomidate as an induction and maintenance agent in unpremedicated fit outpatients undergoing minor gynaecological operations.
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PMID:Alfathesin and etomidate for minor outpatient anaesthesia. 713 1

Etomidate 0.3 mg/kg was injected in 30 seconds to patients submitted to coronary surgery under ECC (output = 2.4 l/min/m2) and moderate hypothermia (29 degrees). The effect of this injection on the EEG was investigated in 3 patients by the traditional EEG monitoring (bipolar fronto-parietal derivation) as well as in 12 patients by the Berg-Fourier spectral analysis. At 29 degrees C etomidate induces an EEG depression in the form of burst suppression periods of 3 to 10 seconds lasting for about 4 minutes. After etomidate injection, the electric activity measured between 0.5 Hz and 32 Hz in 7 patients remained for 4.5 minutes (+/- 1.5 min.) lower than 20% of the value noted prior to the injection. The significance of this important EEG decrease as well as the possible protective effect of etomidate against cerebral anoxia are discussed.
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PMID:Hypothermia and etomidate. Electroencephalographic aspects. 745 67

Reduction of cerebral blood flow below a critical threshold for a protracted time interval results in irreversible metabolic events culminating in cell death. The development of agents capable of extending the tolerable ischemic interval is of great importance as such agents may allow time for therapeutic measures to be accomplished which could restore cerebral perfusion. This issue is of particular pertinence in the treatment of complex cerebrovascular diseases when local (or global) cerebral blood flow must be interrupted during vascular reconstruction. Thiopental achieved great popularity once protective properties were demonstrated experimentally. Unfortunately, serious cardiovascular depression associated with high-dose barbiturates as well as prolonged duration of action may decrease collateral flow and limit their utility. Etomidate is a nonbarbiturate carboxylated imidazole which is capable of similar cerebral metabolic suppression without significant cardiac side effects. Accumulating experimental evidence supports the protective properties of this drug and suggests that it may be valuable clinically for this purpose. Significant adrenal suppression is a major toxic effect that must be treated if large doses or protracted administration is planned.
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PMID:Cerebral protective effects of etomidate: experimental and clinical aspects. 845 60

We reviewed charts of 28 consecutive depressed psychiatric inpatients who had received electroconvulsive therapy (ECT). As a preliminary investigation, we compared the effects of thiopental and etomidate anesthesia on seizure duration. Etomidate, a nonbarbiturate, has been shown to enhance seizure activity in other contexts. The mean age of our sample was 64 years. Because each patient received both etomidate and thiopental at various sessions during their course of ECT, each patient served as his or her own control. The mean proportion of etomidate sessions per patient was 54%. Mean seizure durations were significantly longer (p < 0.001) for the etomidate sessions as compared with the thiopental sessions. In contrast to some prior reports we found that the use of etomidate anesthesia in our sample of 28 consecutive inpatients enhanced seizure duration in ECT. Although controversial, some have advocated that longer seizure times will enhance effectiveness of ECT. We could not compare the anesthetic agents' clinical efficacy in relieving depression due to the retrospective nature of our study.
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PMID:Etomidate anesthesia increases seizure duration during ECT. A retrospective study. 847 38

Intraoperative monitoring of myogenic transcranial motor evoked responses (tc-MERs) requires an anesthetic technique that minimally depresses response amplitudes. Acceptable results have been obtained during opioid/N2O anesthesia, provided that the concentration of N2O does not exceed 50%. However, this technique may necessitate supplementation with additional agents to achieve adequate depth of anesthesia. Etomidate and ketamine have been reported anecdotally or in nonsurgical situations to produce little tc-MER depression. We investigated the effects on tc-MER amplitude and latency of supplementation of a sufentanil/N2O anesthetic with etomidate or ketamine in patients undergoing spinal instrumentation. Anesthesia was induced with etomidate 0.3 mg/kg and sufentanil 1.5 mg/kg and maintained with sufentanil 0.5 mg/kg/h and N2O 50%. Muscle relaxation was kept at 25% of control. Paired transcranial electrical stimulation was performed. Each patient randomly received either ketamine (0.5 mg/kg) or etomidate (0.1 mg/kg) as a single bolus intravenously, during stable surgical conditions. Triplicate tc-MERs were recorded from the tibialis anterior muscles before and 2, 5, 10, and 15 min after drug administration. Administration of ketamine did not significantly change tc-MER amplitudes, whereas etomidate resulted in a transient amplitude depression to 72% of control (p < 0.05) at 2 min after injection. Latency remained unchanged with both drugs. In conclusion, the data suggest that both ketamine (0.5 mg/kg) and etomidate (0.1 mg/kg) can be used to supplement sufentanil/N2O anesthetic without disrupting tc-MER monitoring.
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PMID:The use of ketamine or etomidate to supplement sufentanil/N2O anesthesia does not disrupt monitoring of myogenic transcranial motor evoked responses. 923 84

Many factors influence seizure duration associated with electroconvulsive therapy (ECT). This is a chart review study to assess seizure duration measured with both electroencephalography and electromyography after anesthetic induction with either thiopentone or etomidate. Thirty-seven patients receiving ECT for depression were entered into the study, and a pair of seizures was measured from each patient. Alternate induction agents were used in sequential pairings, and the study was controlled for interval between seizures, laterality, and percent energy. Etomidate was associated with a significantly (p = 0.0002, F = 15.84, df = 1, analysis of variance) longer seizure duration (mean = 34.43 s, SD = 16.06) than thiopentone (mean = 21.73 s, SD = 9.33).
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PMID:Anesthetic induction for ECT with etomidate is associated with longer seizure duration than thiopentone. 964 4

With the increased use of intraoperative monitoring of the central nervous system (CNS) has come a need for better understanding of the effects of anesthetic agents on intraoperative recordings. The commonly used anesthetic agents and their effects on intraoperative electroencephalography (EEG) and evoked potentials (EP) are discussed. Halogenated inhalational anesthetics produce dose-related reduction in EEG amplitude and frequency after an initial activation. They also produce dose-related decreases in amplitude and increases in latency of sensory evoked potentials (SEP) that are most marked in cortically generated components. Subcortical, spinal, and peripheral evoked responses are less affected. Responses in the motor pathways are recordable in the epidural space; however, the relative contributions of sensory and motor tracts may be changed when both are present. Muscle responses are easily suppressed after spinal and motor cortex stimulation, probably by anesthetic effect at the anterior horn cells of the spinal cord. Intravenous analgesic agents (opioids, ketamine) are associated with less marked changes in EEG and evoked responses, with some increases in amplitude of cortically generated SEP caused by ketamine. Intravenous sedative-hypnotic drugs (droperidol, barbiturates, benzodiazepines, etomidate, propofol) produce dose-related depression of the EEG after initial activation and dose-related depression of evoked responses to a lesser extent than do the inhalation agents. Etomidate is associated with amplitude enhancement of EEG and cortically generated SEP. Muscle relaxants have minimal effect on the EEG and SEP. Their use, however, may alter muscle recordings from motor tract stimulation. These effects and their relevance to the choice of agents for specific monitoring techniques are discussed.
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PMID:Anesthetic effects on electrophysiologic recordings. 968 59


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