AccScience Publishing / STI / Volume 46 / Issue 1 / DOI: 10.36922/sti.0301
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REVIEW

Etomidate is Associated with a Reduced Incidence of Systemic Inflammatory Response Syndrome after Thoracoscopic Lung Resection: A Retrospective Analysis

Yunhua Wang1† ,  Jia Chen1† ,  Wanyou He1 ,  Lei Zhang1 ,  Chuangqiang Zhang1 ,  Xueqin Zheng1 ,  Hong Wang1 ,  Jian He1* ,  Hanbing Wang1*
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1 The First People’s Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan, China
†These authors contributed equally to this work.
STI 2026, 46(1), 0301 https://doi.org/10.36922/sti.0301
Received: 16 September 2025 | Revised: 17 January 2026 | Accepted: 26 January 2026 | Published online: 14 April 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Pulmonary complications remain frequent and are a major source of morbidity after thoracic surgery. In this study, we retrospectively examined whether the choice of intravenous general anesthetic—etomidate versus propofol—is associated with the postoperative incidence of systemic inflammatory response syndrome (SIRS) after thoracoscopic lung resection. Patients who underwent thoracoscopic lung resection between February 2022 and May 2024 were included in the analysis. The participants were categorized into two groups based on the intravenous general anesthetic agent administered: etomidate or propofol. Propensity score matching (1:2) was employed to balance baseline characteristics, including age, body mass index, operation duration, and anesthesia duration, between the etomidate group and the propofol group. SIRS occurred in 29.2% (66/226) of patients in the etomidate group compared to 38.7% (175/452) in the propofol group, indicating a significantly higher incidence in the propofol cohort (p < 0.05). Furthermore, respiratory failure was more prevalent among patients receiving propofol than among those receiving etomidate (18.6% vs. 12.4%; p < 0.05). Compared with the propofol group, the etomidate group exhibited significantly lower postoperative systemic immune-inflammation index, and the propofol group demonstrated a higher incidence of intraoperative hypotension. However, no significant differences were observed between the two groups regarding respiratory infections, occurrences of pneumothorax, the proportion of patients requiring vasoactive agents, time to extubation, duration of stay in the post-anesthesia care unit, and the length of hospital stay. In conclusion, compared with propofol, etomidate was associated with a lower incidence of SIRS and a reduced risk of respiratory failure. These findings suggest that etomidate may offer advantages in mitigating inflammatory responses in patients undergoing thoracoscopic lung resection.

Keywords
Thoracoscopic lung resection
Etomidate
Propofol
Systemic inflammatory response syndrome
Conflict of interest
The authors declare no conflict of interest.
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Surgical Technology International, Electronic ISSN: 1090-3941 Published by AccScience Publishing
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