Abstract: Background Etomidate was widely used for general anesthesia before due to its fast recovery from unconsciousness, stable hemodynamics, little respiratory depression, and cerebral protection, etc. The side effects of etomidate on endocrine system, especially the inhibition on adrenal cortex impacted its clinical use. However, recent studies show that etomidate does not cause significant suppression of adrenal cortex when it is used for anesthesia induction or short time maintenance by intravenous infusion. Objective To summarize the recent researches about the feasibility of etomidate for anesthesia induction and maintenance in critical patients and the new research directions and experimental designs of reducing adrenal cortex suppression caused by etomidate. Content The mechanisms of adrenal cortex suppression caused by etomidate and its clinical application were reviewed. Trend Along with the in?蛳depth study of adrenal cortex suppression caused by etomidate, it is well recognized that etomidate can be safely used for anesthesia induction and maintenance in non?蛳critically ill patients, but its clinical use in critically ill patients is still under disputation. Small dose of drug pretreatments and modifications of molecular structure to reduce adrenal cortex suppression caused by etomidate will become to be new research directions.
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