From the FDA Drug Label
The dose for induction of anesthesia in adult patients and in pediatric patients above the age of ten (10) years will vary between 0. 2 mg/kg and 0.6 mg/kg of body weight, and it must be individualized in each case. The usual dose for induction in these patients is 0. 3 mg/kg, injected over a period of 30 to 60 seconds. Smaller increments of intravenous etomidate may be administered to adult patients during short operative procedures to supplement subpotent anesthetic agents, such as nitrous oxide.
The recommended dose of etomidate for procedural sedation is 0.2-0.6 mg/kg of body weight, with a usual dose of 0.3 mg/kg. However, the exact dose may need to be individualized for each patient. For short procedures, smaller increments of etomidate may be administered to supplement other anesthetic agents 1.
- The dose range is 0.2-0.6 mg/kg.
- The usual dose is 0.3 mg/kg.
- Dosing should be individualized.
From the Research
Introduction to Etomidate for Procedural Sedation
Etomidate, also known as Amidate, is a short-acting intravenous anesthetic agent used for procedural sedation. It is valued for its ability to provide effective sedation with minimal impact on respiratory and cardiovascular functions.
Recommended Dose of Etomidate
The recommended dose of etomidate for procedural sedation is typically in the range of 0.1 to 0.2 mg/kg administered as an intravenous bolus. This dosage range is supported by various studies, including those by 2 and 3, which demonstrated the efficacy and safety of etomidate for procedural sedation in emergency department settings.
Key Considerations for Etomidate Administration
- Onset and Recovery: Etomidate has a rapid onset of action and allows for quick recovery, making it suitable for short, painful procedures.
- Hemodynamic Stability: Etomidate is known for its minimal effects on hemodynamics, which is a significant advantage in patients with cardiovascular instability.
- Respiratory Depression: While etomidate has a lower risk of respiratory depression compared to other sedatives, it is not devoid of this risk, particularly in older patients or those receiving higher doses, as noted by 3 and 4.
- Myoclonus: Myoclonus is a common side effect of etomidate, occurring in a significant percentage of patients, as reported by 5 and 6.
Comparison with Other Sedatives
Etomidate has been compared with other sedatives like midazolam and propofol in various studies. For example, 5 found etomidate to have a higher efficacy and shorter induction and recovery times compared to midazolam in pediatric patients. Meanwhile, 6 reported that etomidate and propofol appear equally safe for procedural sedation, although etomidate had a lower rate of procedural success and a higher incidence of myoclonus.
Conclusion
In conclusion, etomidate is a valuable agent for procedural sedation, offering rapid onset, minimal hemodynamic effects, and quick recovery. The recommended dose ranges from 0.1 to 0.2 mg/kg, and its administration should be tailored to the individual patient's needs and monitored closely for potential side effects like respiratory depression and myoclonus, as highlighted by studies such as 2, 3, 4, 5, and 6.