Recent progress in the development of etomidate analogues

TL;DR

This paper reviews recent developments in modifying etomidate to reduce its side effects while maintaining its anesthetic effectiveness.

Contribution

The paper provides a comprehensive review of recent structural modifications to etomidate and their clinical implications.

Findings

Structural modifications aim to reduce adverse effects like adrenal suppression and myoclonus.

Compounds like CPMM and ET-26HCI have reached clinical trials but still face challenges.

The review highlights pharmacological properties and clinical translation of novel etomidate analogs.

Abstract

Etomidate is a widely utilized anaesthetic agent for the induction of general anesthesia, recognized for its rapid onset and minimal hemodynamic suppression effects. However, its clinical application is constrained by several adverse effects, including adrenal cortex suppression, postoperative nausea and vomiting, and myoclonus. In recent years, there has been a growing global research focus on structural modifications of the etomidate molecule, aiming to simultaneously ameliorate its adverse effects and optimize its hemodynamic stability efficacy. Methoxycarbonyl-etomidate and carboetomidate are inhibited due to the accumulation of their metabolites. CPMM and ET-26HCI have entered the clinical trial stage, but there are still adverse reactions and challenges for the next phase of research. This comprehensive review systematically examines recent scientific advancements in this field, focusing on structural modifications, pharmacological properties, and clinical translation of these novel compounds.

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