Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Emergency and trauma care research center, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Anesthesiol. 2023 Apr 1;23(1):104. doi: 10.1186/s12871-023-02065-5.
Etomidate is an imidazole derivative that is widely used in the emergency department for Rapid Sequence Intubation (RSI). Although it has a safe hemodynamic profile, there are some concerns about its suppressant effects on the adreno-cortical axis. Vitamin C, as an antioxidant, can play a protective role in this issue.
In a controlled clinical trial, we studied adult traumatic patients who needed RSI with etomidate. In one group underwent RSI with etomidate and cortisol levels were measured three hours later. In the other group, we administered one gram of vitamin C before etomidate administration, and the cortisol level was measured three hours later.
Fifty-one patients have been studied. The serum cortisol level was significantly lower after RSI with etomidate in both groups. In the Vitamin C group, there was a significantly higher cortisol level after RSI in comparison to the control group.
Etomidate can suppress the cortisol level in trauma patients who undergo RSI. Vitamin C can reduce this suppressant effect of etomidate.
IRCT registration number: IRCT20090923002496N11, URL of trial registry record: https://en.irct.ir/trial/34586 , Date of trial registration: 19/04/2019. Full date of the first registration: 30/05/2019.
依托咪酯是一种咪唑衍生物，广泛应用于急诊科的快速序贯诱导（RSI）。尽管它具有安全的血液动力学特征，但人们对其对肾上腺皮质轴的抑制作用仍存在一些担忧。维生素 C 作为一种抗氧化剂，可以在这个问题上发挥保护作用。
在一项对照临床试验中，我们研究了需要依托咪酯进行 RSI 的成年创伤患者。一组在接受依托咪酯 RSI 后三小时测量皮质醇水平，另一组在给予依托咪酯前给予 1 克维生素 C，三小时后测量皮质醇水平。
共研究了 51 例患者。两组患者 RSI 后血清皮质醇水平均明显降低。与对照组相比，维生素 C 组 RSI 后皮质醇水平显著升高。
依托咪酯可抑制行 RSI 的创伤患者的皮质醇水平，维生素 C 可减轻依托咪酯的这种抑制作用。
IRCT 注册号：IRCT20090923002496N11，试验注册网址：https://en.irct.ir/trial/34586，试验注册日期：2019 年 4 月 19 日，首次注册完整日期：2019 年 5 月 30 日。
