Effect of Vitamin C on adrenal suppression following etomidate for rapid sequence induction in trauma patients: A randomized clinical trial

Abstract

Abstract Background: Etomidate is an imidazol derivative which widely used in emergency department for Rapid Sequence Intubation (RSI). Although it has a safe hemodynamic profile but there are some concerns about its suppressant effects on adreno-cortical axis. Vitamin C as an antioxidant can play a protective role in this issue. Method: In a controlled clinical trial, we studied adult traumatic patients who need RSI with etomidate. In one group underwent RSI with etomidate and cortisol level measured three hours later. In the other group we administrated one gram of vitamin C before etomidate administration and cortisol level measured three hours later. Results: fifty-one patients has been studied. Serum cortisol level was significantly lower after RSI with etomidate in both groups. In Vitamin C group there was a significant higher cortisol level after RSI in comparison to control group. Conclusion: Etomidate can suppress the cortisol level in traumatic patients underwent 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: 2019-04-19