By R. S. Reneman, P. A. J. Janssen (auth.), Prof. Dr. med. A. Doenicke (eds.)
The query tips to result in basic anaesthesia without difficulty has been requested many times by means of anaesthetists and pharmacologists. P. A. JANSSEN constructed etomidate and released this substance in 1971 as "a powerful short-acting and comparatively atoxic intravenous hypnotic agent in rats". In 1974 after a number of years of experimental and medical trial the barbiturate-free hypnotic etomidate (soon advertised as Hypnomidate) used to be brought to varied auditors on the get together of the IV. eu Congress of Anaesthesiologists in Madrid. because the authors prolonged their essays, the reality of the current e-book is given. the belief mentions the recent resolution of etomidate base in 35 % propylene glycol. it's anticipated that the disadvantageous results - venous soreness in the course of injection and linked involuntary muscle stream- will principally be eradicated through the use of the hot formulation of etomidate after premedication of fentanyl. Mlinchen, August 1977 Alfred DOENICKE desk OF CONTENTS The Experimental Pharmacology of Etomidate, a brand new powerful, Short-Acting Intravenous Hypnotic (R. S. RENEMAN and P. A. JANSSEN) •. . . . •• 1 Protein Binding of Etomidate (G. A. MANNES and A. DOENICKE) ••••. . . 6 The impact of Intra-Arterial Injection of Etomidate and Thiopental at the Skeletal Muscle- and Arterial Wall-Structures (R. S. RENEMAN, F. VERHEYEN, R. KRUGER, W. VAN GERVEN and M. BORGES) . . •. . •• nine interplay among Etomidate and the Antihypertensive brokers Propanolol andoC-Methyl-Dopa (R. S. RENEMAN, W. VAN GERVEN and R. KRUGER) ••. •. . . 15 Teratogenicity of Etomidate (A. DOENICKE and M. HAEHL) •. ••. •.
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Extra info for Etomidate: An Intravenous Hypnotic Agent First Report on Clinical and Experimental Experience
The combination with diazepam and fentanyl prolongs the stages of anaesthetic action of etomidate; it suppresses the motor phenomena (myocloni, dyskinesia) sometimes observed after the administration of etomidate alone. 3. The EEG changes lead us to assume a hypnotic effect of etomidate which is mainly based on an impairment of neocortical function. However, etomidate does not produce satisfactory analgesia for surgical interventions, it thus does not seem to provoke a sufficient blockade of afferences to the thalamic structures that are important for pain perception.
Applizierbaren Hypnotikum. Anaesthesist 22, 357 (1973) • 30 5. : Histamine release after intravenous application of short-acting hypnotics. A comparison of Etomidate, Althesin (T 1341) and Propanidid. Anaesth. 45, 1097 (1973). 6. v. Hypnotika (Propanidid, Etomidate, Methohexital). Anaesthesist 22, 353 (1973). 7. : Etomidate, R-(+)-Ethyl-l-~-methylbenzyl) imidazole-5-carboxylate (R 16 659), a potent, short-acting and relatively atoxic intravenous hypnotic agent in rats. Arzneimittel-Forsch. 21, 1234 (1971).
22 Summary In this study the interaction between the anti-hypertensive agents propranolol andOC-methyl-dopa and etomidate was studied in unpremedicated, non-anaesthetized labradors. No interference was found between these anti-hypertensive drugs and etomidate, at least as far as the effect on heart rate, systolic and diastolic aortic blood pressure, respiratory rate and duration of sleep is concerned. Zusarnmenfassung In diesem Versuch wird die Wechselwirkung zwischen den antihypertensiven Mitteln Propranolol, DC-Methyldopa und Etomidate an nicht vorbehandelten und nicht anasthesierten Labrador-Hunden geprlift.