Featured Research

from universities, journals, and other organizations

New concerns over safety of common anesthetic

Date:
December 13, 2013
Source:
International Anesthesia Research Society (IARS)
Summary:
Patients receiving the widely used anesthesia drug etomidate for surgery may be at increased risk or mortality and cardiovascular events, according to a study.

Patients receiving the widely used anesthesia drug etomidate for surgery may be at increased risk or mortality and cardiovascular events, according to a study in the December issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

Related Articles


The study adds to safety concerns over etomidate's use as an anesthetic and sedative drug. "There is accumulating evidence for an association between mortality and etomidate use, both in critically ill patients and now in [non-critically ill] patients undergoing noncardiac surgery," according to an editorial by Drs Matthieu Legrand and Benoît Plaud of Paris-Diderot University.

In Ill Surgical Patients, Increased Risks with Etomidate

The editorial comments on a new study by Dr Ryu Komatsu of the Cleveland Clinic and colleagues, who assessed the risk of adverse outcomes in patients receiving etomidate for induction of anesthesia. Rates of death and cardiovascular events in about 2,100 patients receiving etomidate were compared to those in a matched group of 5,200 patients receiving induction with a different intravenous anesthetic, propofol. All patients had severe but non-critical medical conditions -- ASA physical status III or IV -- and were undergoing noncardiac surgery.

The results showed significantly higher risks in patients receiving etomidate. The etomidate group had a 250 percent increase in the risk of death within 30 days. (Absolute risk of death was 6.5 percent with etomidate versus 2.5 percent with propofol.) Patients receiving etomidate also had a 50 percent increase in the risk of major cardiovascular events.

The results are "striking and troubling," but the study is not the first to raise safety concerns over etomidate, according to Drs Legrand and Plaud write. Previous reports have suggested an increased risk of death in patients receiving etomidate in emergency situations or during critical illness, particularly sepsis. Subsequent randomized trials did not show an increased risk of death in critically ill patients receiving etomidate.

It's unclear how etomidate -- a drug with only short-lasting effects -- can affect patient outcomes several weeks later. Borrowing a metaphor from physics, Drs Legrand and Plaud suggest that it may represent a so-called butterfly effect, with "very small differences in the initial state of a physical system [making] a significant difference to the state at some later time."

While noting that the new study has some important limitations, Drs Legrand and Plaud write, "These findings are of major importance in light of the high number of patients who potentially receive etomidate each year worldwide." Large-scale studies will be needed to definitively establish the safety of etomidate; a study in critically ill patients is already underway. Pending those results, the editorial authors conclude, "Since safe and efficient alternatives exist, a wise choice might certainly be the use of other anesthetic agents for induction of anesthesia."


Story Source:

The above story is based on materials provided by International Anesthesia Research Society (IARS). Note: Materials may be edited for content and length.


Journal Reference:

  1. Matthieu Legrand, Benoît Plaud. Etomidate and General Anesthesia. Anesthesia & Analgesia, 2013; 117 (6): 1267 DOI: 10.1213/ANE.0000000000000003

Cite This Page:

International Anesthesia Research Society (IARS). "New concerns over safety of common anesthetic." ScienceDaily. ScienceDaily, 13 December 2013. <www.sciencedaily.com/releases/2013/12/131213135316.htm>.
International Anesthesia Research Society (IARS). (2013, December 13). New concerns over safety of common anesthetic. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2013/12/131213135316.htm
International Anesthesia Research Society (IARS). "New concerns over safety of common anesthetic." ScienceDaily. www.sciencedaily.com/releases/2013/12/131213135316.htm (accessed November 27, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) — The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com
Experimental Ebola Vaccine Shows Promise In Human Trial

Experimental Ebola Vaccine Shows Promise In Human Trial

Newsy (Nov. 27, 2014) — A recent test of a prototype Ebola vaccine generated an immune response to the disease in subjects. Video provided by Newsy
Powered by NewsLook.com
Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) — Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) — Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins