European journal of anaesthesiology
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Etomidate is an imidazole-derived hypnotic agent preferentially used for rapid sequence induction of anaesthesia because of its favourable haemodynamic profile. However, 11β-hydroxylase inhibition causes adrenal insufficiency with potentially fatal consequences in specific populations. We review the arguments against the liberal administration of etomidate in critically ill, and especially septic, patients. ⋯ Based on these randomised controlled trials, the use of etomidate should be avoided in unstable trauma patients. Midazolam and ketamine are two valid alternatives with similar intubation and haemodynamic conditions as etomidate but without its adverse effects. Therefore, for safety reasons, etomidate should be avoided in the critical conditions of sepsis and trauma.
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Comparative Study
A secure and rapid method for orotracheal intubation of laboratory rats utilising handy instruments.
Tracheal intubation of anaesthetised rats for laboratory experiments remains an essential yet challenging procedure. ⋯ Tracheal intubation for laboratory rats can be securely and safely completed with the modified method employing a short learning curve and easily available devices.
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Editorial Comment
Etomidate for critically ill patients: let us clarify the debate.