Which anaesthetic is associated with adrenal suppression?

Etomidate is known to be associated with adrenal suppression, making it the correct choice. This linear connection is primarily due to etomidate’s mechanism of action, as it inhibits 11-beta-hydroxylase, an enzyme involved in the synthesis of cortisol in the adrenal glands. As a result, when etomidate is administered, it can lead to transient adrenal insufficiency, particularly in patients with already compromised adrenal function or those who are receiving it over extended periods.

The other anesthetics mentioned do not have a similar profile regarding adrenal suppression. For instance, Propofol does not influence adrenal function to a clinically significant extent; instead, it is known for its rapid onset and recovery, making it popular for outpatient procedures. Ketamine, while a dissociative anesthetic, also does not have any direct impact on adrenal hormone production. Sodium thiopentone, a barbiturate, can cause sedation and anesthesia but does not exert an effect on adrenal suppression. Therefore, etomidate stands out in this context due to its unique pharmacological effects on adrenal output, clarifying why it is the anesthetic typically highlighted for this particular concern.