Efficacy and Safety of Etomidate Used as a Sedative for Rapid Sequence Intubation in the Emergency Department

Choi, Sang Cheon; Kim, Gi Woon; Min, Young Gi; Yoon, Sang Kyu; Cho, Joon Pil; Jung, Yoon Seok

Abstract

PURPOSE: The purpose of this study was to estimate the efficacy and the safety of etomidate for rapid sequence intubation (RSI) in the emergency department.
METHODS
A retrospective analysis by chart review was done for patients who had needed intubation in the emergency department of Ajou university hospital from July 1999 to June 2000.
RESULTS
Three hundred (300) patients were enrolled in this study. Etomidates were used for 170 patients and Thiopental for 130 patients. In the Etomidate group, the average systolic blood pressures (SBP) were 127.7+/-42.2mmHg prior to etomidate administration and 125.6+/-40.9mmHg after. The average diastolic blood pressures (DBP) were 78.1+/-22.4 mmHg prior to etomidate administration and 79.1+/-21.3 mmHg after. There was no significant change in blood pressure after the use of etomidate. The average intubation time was about 3.9 minutes. Eight (8) patients experienced myoclonus and three (3) of vomiting after the use of etomidate. In the thiopental group, statistically significant decreases in the average SBP and DBP were seen after the administration of thiopental sodium. Twelve (12) patients had decreased blood pressure and one (1) patient arrhythmia after Thiopental administration. The average intubation time was about 5.9 minutes.
CONCLUSION
The intubation time for etomidate group was superior to that for thiopental group. Also, in the etomidate group, no significant changes in the hemodynamic variables were noted during RSI. This study supports the efficacy and the safety of etomidate for RSI in the emergency department.