• Br J Anaesth · Jan 2025

    Editorial Review

    Etomidate and its derivatives: time to say goodbye?

    • J Robert Sneyd and Beatrijs I Valk.
    • Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK. Electronic address: robert.sneyd@plymouth.ac.uk.
    • Br J Anaesth. 2025 Jan 1; 134 (1): 111311-13.

    AbstractEtomidate, an intravenous hypnotic used for anaesthesia and critical care, is known for its undesirable side effects, including pain on injection, myoclonus, and adrenocortical depression. Despite its continued clinical use because of its haemodynamic stability and rapid onset and offset of effect, alternatives like propofol, ketamine, and remimazolam offer fewer drawbacks. Recent efforts to improve etomidate through chemical modifications, such as methoxyethyl etomidate hydrochloride (ET-26), have shown limited success, with persistent issues like involuntary muscle movements and adrenocortical suppression. We suggest that it might be time to move on from etomidate and focus on developing new anaesthetic agents.Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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