A. Donmez et al., THE EFFECT OF ETOMIDATE INDUCTION ON PLASMA-CORTISOL LEVELS IN CHILDREN UNDERGOING CARDIAC-SURGERY, Journal of cardiothoracic and vascular anesthesia, 12(2), 1998, pp. 182-185
Citations number
23
Categorie Soggetti
Anesthesiology,"Peripheal Vascular Diseas","Cardiac & Cardiovascular System
Objective: To investigate the effect of a single induction dose of eto
midate on plasma cortisol and adrenocorticotrophic hormone (ACTH) leve
ls in pediatric patients with congenital heart disease. Design: A pros
pective, randomized study. Setting: A university hospital. Participant
s: Thirty children undergoing cardiopulmonary bypass. Interventions: P
atients were randomly allocated into two groups to receive etomidate,
0.3 mg/kg, and fentanyl, 1 mu g/kg, or ketamine, 1 mg/kg, and fentanyl
, 1 mu g/kg intravenously, for anesthesia induction. Anesthesia was ma
intained with 50% nitrous oxide and 0.5% isoflurane in oxygen. Plasma
cortisol and ACTH levels were measured on five occasions: preoperative
ly, after induction of anesthesia, after cross-clamping, at the end of
surgery, and 24 hours postoperatively. Measurements and Main Results:
Plasma cortisol levels of the etomidate group decreased with anesthes
ia induction and remained significantly low during cardiopulmonary byp
ass, at the end of operation, and 24 hours postoperatively. Plasma cor
tisol levels of the etomidate group after the anesthesia induction, du
ring cardiopulmonary bypass, and at the end of the operation were sign
ificantly lower than the ketamine group. Conclusion: These results sho
w that etomidate is a suitable agent for suppressing the increase in c
ortisol levels associated with the stress response caused by cardiopul
monary bypass in children with congenital heart defects, and can be us
ed safely. Copyright (C) 1998 by W.B. Saunders Company.