Question - Etomidate is widely used for induction of general anesthesia and sedation including in elderly and/or hemodynamically unstable patients. What is the most prominent problem associated with etomidate when this drug is used as an anesthesia induction agent?
Answer- The cited article points out that “Myoclonus…… is the most prominent problem during induction of anesthesia with etomidate.” These authors further state “The primary action of etomidate on the central nervous system is through the GABA A receptor and results in hypnosis. The neurologic mechanism by which etomidate produces myoclonus is unclear.” (Wang J et al. Efficacy and safety of opioids for the prevention of etomidate-induced myoclonus: A meta-analysis. 2018 Am J Therapeutics 25: e517-e523)