The Study
The Effects of Single-Dose Etomidate Versus Propofol on Cortisol Levels in Pediatric Patients Undergoing Urologic Surgery: A Randomized Controlled Trial
This study is like a fair race between two types of medicine to see which one makes a stress hormone (cortisol) drop more after surgery. Because the kids were randomly assigned and no one knew which medicine they got, we can say etomidate really does cause cortisol to drop more than propofol.
Analysis score
Maximum 90 for a randomized controlled trial.
Where the score came from
Doctors gave two different sleep medicines to kids having surgery and checked their stress hormone (cortisol) levels before and after.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 555 / 100
Quality score
Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Even though cortisol dropped a lot with etomidate, the kids didn’t have more problems like low blood pressure or slow recovery — so the drop didn’t hurt them in this short-term setting.
- 2Kids who got etomidate had much lower cortisol for about 24 hours (from when they left recovery until 8 AM the next day).
- 3Kids who got propofol stayed normal, except for a tiny spike before surgery.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Anesthesia & Analgesia
Year
2015
Authors
Yi Du, Yi-jun Chen, Bin He, Ying-Wei Wang
Related Content
Claims (6)
In healthy children aged 3 to 12 undergoing urologic surgery, a single intravenous dose of etomidate at 0.3 mg/kg reduces salivary cortisol levels for about 24 hours compared to propofol, with lower levels persisting from discharge until 8:00 AM the next morning, without affecting clinical outcomes.
A single dose of etomidate in healthy children lowers cortisol levels for about 24 hours, with levels staying below normal from the time they leave the hospital until 8:00 AM the next day, after which cortisol returns to its original level.
Salivary cortisol levels accurately reflect the stress response to anesthesia in children aged 3 to 12 years, showing predictable daily rhythms in healthy children and distinct changes during anesthesia.
In healthy children aged 3 to 12 years undergoing urologic surgery, a single intravenous dose of propofol at 2 mg/kg does not change salivary cortisol levels from before surgery to 24 hours after surgery, except for a small temporary increase at 11:00 AM before the procedure.
In healthy children having urologic surgery, one dose of etomidate lowers cortisol levels more than propofol, but does not change blood pressure, recovery speed, or risk of complications.
When cortisol levels are artificially lowered during their natural morning peak, the body's internal clock becomes disrupted.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.