• Güniz Meyancı Köksal, Emre Erbabacan, Yusuf Tunalı, Gülşah Karaören, Suphi Vehid, and Huseyin Öz.
• Department of Anesthesiology and Reanimation, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
• Ulus Travma Acil Cer. 2015 Sep 1; 21 (5): 358-65.

BackgroundThe study aimed to evaluate and compare the effects of a single dose of etomidate and the use of a steroid injection prior to etomidate during rapid sequence intubation on hemodynamics and cortisol levels.MethodsSixty patients were divided into three groups (n=20). Before intubation, and at 4 and 24 hours, blood samples were taken for cortisol measurements and hemodynamic parameters (systolic-diastolic-mean arterial pressure, heart rate), and SOFA scores were recorded. Intubation was achieved with 0.3 mg/kg etomidate IV in Group I, 0.3 mg/kg etomidate following 2 mg/kg methylprednisolone IV in Group II, and 0.15 mg/kg IV midazolam in Group III.ResultsMean arterial pressure values were lower in Group I at the 24th hour when compared to Groups II and III. In Group I, heart rate values were higher compared to the other Groups. Cortisol levels were lower in Group I at the 4th and at the 24th hour in Groups II and III.ConclusionAdministration of methylprednisolone 2-4 minutes prior to etomidate use in emergency situations can prevent adrenal insufficiency in patients undergoing rapid sequence intubation. Moreover, midazolam can be used in low induction doses as an alternative to etomidate.

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