All of the following cause myocardial depression, except

The hemodynamic stability seen with etomidate is caused by its lack of effect on the sympathetic nervous system and on the function of the baroreceptor. The minimal effect of etomidate on cardiovascular function sets it apa from other rapid-onset anesthetics. Etomidate has proven useful in patients with valvular or ischemic hea disease who are undergoing noncardiac surgical procedures and in patients with poor cardiac function. In patients receiving etomidate during induction of anesthesia, more hypeension and tachycardia occur after etomidate compared with propofol. The myocardial oxygen supply-to-demand ratio is well maintained. Myocardial contractility and cardiac output are usually unchanged. Etomidate lacks analgesic efficacy, however, and must be combined with an opiate to prevent hemodynamic peurbations during laryngoscopy and intubation. In the setting of hemorrhagic shock, etomidate has advantages for the induction of anesthesia. In contrast to other drugs, the pharmacodynamics and pharmacokinetics of etomidate were minimally altered in a pig model of hemorrhagic shock. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e