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Summary of the Day

Perioperative Management of Patients With Type 2 Diabetes Mellitus

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Question of the Day

A 55-year-old man develops refractory hypotension after a 8-hour anesthetic consisting of etomidate and sufentanil infusions. Which of the following BEST explains this patient’s hypotension?

Question of the Day
A 55-year-old man develops refractory hypotension after a 8-hour anesthetic consisting of etomidate and sufentanil infusions. Which of the following BEST explains this patient’s hypotension?
Your Answer
Correct Answer

Explanation

Etomidate is a reversible inhibitor of 11β-hydroxylase, which is critical to adrenocortical steroid synthesis. Thus, etomidate suppresses corticosteroid synthesis and leads to primary adrenal suppression, which typically manifests as refractory hypotension. Increases in patient mortality can be observed after a single dose of etomidate, which may be related to adrenal suppression.

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