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My experience is similar.  The duration of sedation isn't good enough for most procedures and since it really doesn't have analgesic properties, there are too many other agents that work too well for it to be valuable.  Oddly though, I have found it useful for assisting the ENT in bedside I&D of peritonsilar abscesses.  It gives just enough sedation for the ENT to inject the lidocaine and the patient is waking up about the time he drains it.  Have suction ready and if you time it right, the patient recovers his/her ability to fight the procedure just as you're finishing up.
 
Otherwise, I use etomidate in elective sedations for brief, non-painful procedures only (CT scans mostly).
 
R. David Smith, MD




________________________________
From: Jason Foland <[log in to unmask]>
To: [log in to unmask]
Sent: Friday, August 14, 2009 2:05:27 PM
Subject: Re: Etomidate for painful procedures

I tried to use it a few times and I found that the duration of sedation was too short (about 2-3 minutes in some patients, expecially with repeat dosing) to be of any real benefit.

Jason



Jason A. Foland, MD
Pediatric Critical Care Physician
Nemours Children's Clinic
www.nemours.org
Medical Director, Pediatric Respiratory Therapy
Sacred Heart Women & Children's Hospital
www.sacred-heart.org
Pensacola, Florida
[log in to unmask]





> Date: Fri, 14 Aug 2009 10:58:27 -0400
> From: [log in to unmask]
> Subject: Etomidate for painful procedures
> To: [log in to unmask]
> 
> I know this has been discussed in the past but when I searched the List it
> seems most discussions are on RSI.
> What are the lists experience and thoughts on the use of etomidate in
> children for painful procedures.
> What doses are being used, any caveats or concerns. Any problems with
> anesthsia dept.
> Thanks in advance.
> 
> -- 
> "Live in such a way that you would not be ashamed to sell your parrot to the
> town gossip." Will Rogers
> 
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
> http://listserv.brown.edu/ped-em-l.html

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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html