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British Journal of Anaesthesia, Vol 79, Issue 3 386-388, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia

SHORT COMMUNICATIONS

Haemolysis after etomidate: comparison of propylene glycol and lipid formulations

A. Doenicke, M. F. Roizen, R. Hoernecke, M. Mayer, P. Ostwald and J. Foss
Institute for Anaesthesiology, Ludwig-Maximilians University, Munich; Department of Anesthesia and Critical Care and the Committee on Clinical Pharmacology, University of Chicago, Chicago, IL, USA

We sought to determine if the solvent in the formulation of etomidate is responsible for haemolysis in patients. In a randomized, prospective, double-blind study of 49 patients undergoing otolaryngological surgery, patients received etomidate dissolved in propylene glycol or in lipid emulsion. Concentrations of free haemoglobin and haptoglobin were measured before and for up to 360 min after injection of etomidate. Free haemoglobin concentrations increased by 216.8 mg litre-1 in patients who received the propylene glycol formulation and by 11.8 mg litre-1 in the lipid emulsion group (P < or = 0.0004). Correspondingly, reductions in haptoglobin concentrations were significantly greater in the propylene glycol group (P < or = 0.002). We conclude that with respect to haemolysis, lipid emulsion is superior to propylene glycol as a solvent for etomidate.
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