thiopental and Adrenal-Insufficiency

The adrenocortical response to a short tetracosactrin (Synacthen) test was studied in 11 patients receiving either etomidate infusion or thiopentone infusion used to maintain anaesthesia for abdominal hysterectomy. Pethidine was used as the narcotic component. The results showed that etomidate infusion (median 28.5 ug/kg/min) completely blocked the adrenocortical response to corticotropin stimulation for at least 24 h after surgery. No suppression was found in patients receiving thiopentone infusion. It is concluded that etomidate cannot be recommended for routine induction and maintenance of anaesthesia.

Topics: Adrenal Cortex; Adrenal Insufficiency; Anesthetics; Cosyntropin; Drug Tolerance; Etomidate; Female; Fentanyl; Humans; Hydrocortisone; Hysterectomy; Imidazoles; Postoperative Complications; Thiopental

Topics: Adrenal Glands; Adrenal Insufficiency; Animals; Barbiturates; Chick Embryo; Chromaffin System; Metabolism; Research; Thiopental; Toxicology

Topics: Addison Disease; Adrenal Insufficiency; Barbital; Humans; Hypoadrenocorticism, Familial; Thiopental