Why would you not resedate with Etomidate??

Question

Why would you not want to resedate a patient with Etomidate??

Answer 1

actually, the adrenal suppression is more of a theoretical concern. you can use an etomidate infusion to keep people continuously sedated if you wanted to and it wouldn't cause any problems. the main reasons for not using it are:

1. there are more cost-effective ways to provide continuous sedation because etomidate wears off quickly. you're better off using ativan or some other long-acting benzodiazepine.

2. etomidate can decrease seizure threshold. meaning in people prone to have seizures, etomidate can cause them to have seizures.

Answer 2

Etomidate is generally used for rapid INITIAL induction of anesthesia, to knock them out, because it is very fast-acting, but has no analgesic (i.e. pain-numbing) properties, so it must be combined with other anesthetics/analgesics. You would not use it a second time to re-sedate because it causes serious adrenal suppression with a second dose, which is obviously undesirable. There are other options available that would do the same thing without the adrenal deficit, and you probably wouldn't need rapid induction for re-sedation either.