[Life-threatening anaphylactoid reaction following etomidate]

In a patient scheduled for coronary artery bypass grafting induction of anaesthesia resulted in a life-threatening anaphylactoid reaction with development of an erythema of the neck. Severity and duration of hypotension and tachycardia were such as to require intensive management and postponement of surgery. Skin tests ruled out any other cause except etomidate. Hence for definite surgery exactly the same induction manoeuvre was chosen, but etomidate was omitted. Anaesthesia and surgery proceeded completely uneventfully. There can be no doubt that this anaphylactoid reaction (grade III according to the classification proposed by Lorenz and Doenicke) was caused by etomidate.