Klinische Wochenschrift

, Volume 62, Issue 21, pp 1011–1013

Etomidate: A selective adrenocortical 11β-hydroxylase inhibitor

  • H. G. Dörr
  • U. Kuhnle
  • H. Holthausen
  • F. Bidlingmaier
  • D. Knorr
Originalien

DOI: 10.1007/BF01711722

Cite this article as:
Dörr, H.G., Kuhnle, U., Holthausen, H. et al. Klin Wochenschr (1984) 62: 1011. doi:10.1007/BF01711722

Summary

To investigate the adrenocortical suppression caused by the anesthetic etomidate, plasma levels of progesterone (P), 17-hydroxyprogesterone (17-OHP), 11-deoxycorticosterone (DOC), corticosterone (B), aldosterone (Aldo), 11-deoxycortisol (S), cortisol (F), and cortisone (E) were measured simultaneously before and after a short-term ACTH stimulation test in a 6.5-year-old boy whose convulsions could be kept under control only with constant etomidate infusions. During etomidate therapy, plasma levels of DOC and S were extremely elevated, the progestins P and 17-OHP were slightly elevated, whereas B and Aldo were in the lower normal range, and F and E were markedly decreased. A short-term ACTH stimulation test during etomidate infusion gave a blunted response of B, Aldo, F and E, whereas the level of DOC remained high and S even further increased. P and 17-OHP showed a positive response to ACTH. The ratios of B/DOC and F/S, which reflect adrenocortical 11β-hydroxylase activity, were extremely decreased during etomidate and did not change after ACTH stimulation. In contrast, the ratios of DOC/P and S/17-OHP, which relect 21-hydroxylase activity, were elevated and remained elevated after ACTH stimulation. After discontinuation of etomidate therapy, all the baseline steroid levels were somewhat elevated, but responded normally to ACTH. These results demonstrate that etomidate causes a specific and reversible blockade of the 11β-hydroxylation of adrenal steroid synthesis.

Key words

EtomidateAdrenocortical suppression17-Deoxysteroids17-Hydroxysteroids

Abbreviations

P

progesterone

DOC

11-deoxycorticosterone

B

corticosterone

Aldo

aldosterone

170HP

17-hydroxyprogesterone

S

11-deoxycortisol

F

cortisol

E

cortisone

ACTH

adrenocorticotrophic hormone

Copyright information

© Springer-Verlag 1984

Authors and Affiliations

  • H. G. Dörr
    • 1
  • U. Kuhnle
    • 1
  • H. Holthausen
    • 1
  • F. Bidlingmaier
    • 1
  • D. Knorr
    • 1
  1. 1.Dr. von Haunersches Kinderspital der Universität MünchenGermany