A 24-year-old previously healthy man is brought to the emergency department after a motor vehicle collision in which he sustained trauma to the left side of the chest and the abdomen. On arrival, the patient is hypotensive and tachycardic. Evaluation reveals left-sided rib fractures and hemoperitoneum due to splenic laceration. Urgent exploratory laparotomy under general anesthesia is planned. In the operating room, etomidate is administered for rapid sequence induction. Which of the following characteristics best describes etomidate as compared to propofol?

Question

A 24-year-old previously healthy man is brought to the emergency department after a motor vehicle collision in which he sustained trauma to the left side of the chest and the abdomen.  On arrival, the patient is hypotensive and tachycardic.  Evaluation reveals left-sided rib fractures and hemoperitoneum due to splenic laceration.  Urgent exploratory laparotomy under general anesthesia is planned.  In the operating room, etomidate is administered for rapid sequence induction.  Which of the following characteristics best describes etomidate as compared to propofol?

Quizplus · Accepted Answer

This patient is hemodynamically unstable (ie, hypotensive, tachycardic). Prior to operative intervention, anesthesia must be induced. Three medications are commonly used because of their rapid onset of action and short duration of effect: In hypotensive patients, anesthesia is often induced with either a hemodynamically neutral agent (etomidate) or one that may improve hemodynamics due to catecholamine release (ketamine). (Choice A) In contrast to ketamine, neither propofol nor etomidate provide an analgesic effect. Educational objective: Etomidate, a GABA agonist, is often used for anesthesia induction to provide sedation and amnesia. It is hemodynamically neutral, but it can result in transient adrenocortical suppression because it inhibits cortisol synthesis.

A 24-Year-Old Previously Healthy Man Is Brought to the Emergency