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Solvent for etomidate may cause pain and adverse effects
A W Doenicke1, M F Roizen, R Hoernecke
1Institute for Anaesthesiology, Ludwig-Maximilians University, München, Germany.
British Journal of Anaesthesia
|February 3, 2000
Summary
The solvent used for etomidate significantly impacts injection side effects. Propylene glycol formulations caused more pain and venous issues compared to lipid emulsions, with no link to histamine release.
Area of Science:
- Anesthesiology
- Pharmacology
- Vascular Biology
Background:
- Etomidate is an anesthetic agent.
- Propylene glycol is a common solvent.
- Lipid emulsions are used for drug formulation.
Purpose of the Study:
- To investigate the role of etomidate's solvent in post-injection pain and side effects.
- To determine if histamine release is associated with etomidate-induced adverse events.
Main Methods:
- A comparative study involving volunteers receiving etomidate in either propylene glycol or lipid emulsion formulations.
- Assessment of pain severity, venous sequelae, and histamine concentrations post-injection.
Main Results:
- A significantly higher incidence of moderate to severe pain and venous sequelae was observed with the propylene glycol formulation compared to the lipid emulsion (P < 0.05).
- Histamine release was minimal and not consistently correlated with pain or venous sequelae in either group.
- Lipid emulsion formulation of etomidate showed a significantly better safety profile regarding injection site reactions.
Conclusions:
- Etomidate formulated in propylene glycol may induce vascular endothelial injury, leading to pain and venous sequelae.
- Etomidate formulated in lipid emulsion appears to be a safer alternative, minimizing injection site adverse events.
- Histamine release is not a significant factor in the side effects observed with etomidate formulations.
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