Etomidate: Coming to an endoscopy unit near you?

In this issue of Gastrointestinal Endoscopy, Kim et al1 present a double-blinded, randomized controlled trial of etomidate versus propofol for patients undergoing EUS. Etomidate bears some similarities to propofol. It is rapidly acting (although not quite as nimble as its more controversial "milk of anesthesia" comparator), is highly protein bound, works by facilitating γ-aminobutyric acid neurotransmission, and has no analgesic qualities.2,3 The penchant of etomidate for not eroding hemodynamic and respiratory function makes it particularly attractive for patients with shock or significant cardiopulmonary disease.

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