Distribution of etomidate in a fatal intoxication

Etomidate is a commonly used anesthetic agent often utilized to induce anesthesia as it has a short half-life and allows for central nervous system depression without causing major cardiovascular disturbances, making it one of the preferred medications for trauma and hemodynamically unstable patients. Thus, etomidate is commonly found during a postmortem drug screen conducted for medicolegal reasons. Concentrations of etomidate in various fluids/tissues have not been reported in the literature. We report of a case of suicide by etomidate with concentrations of 0.40 mg/L in the femoral blood, 0.46 mg/L in the bile, and 0.30 mg/L in the vitreous with a blood alcohol content of 0.119 g/dL. For comparison, we identified two cases in which etomidate was administered during resuscitation after trauma with levels of 0.05 mg/L and < 0.026 mg/L, respectively.