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REVIEW ARTICLE

Etomidate-related fatalities: A systematic review of case reports

Noble Lo1,2* ,  Sue Kwok2,3 ,  Karly Chan2
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1 Educational Research, County South, Lancaster University, Lancaster, United Kingdom
2 College of Professional and Continuing Education, The Hong Kong Polytechnic University, Hong Kong SAR, China
3 The Nursing Council of Hong Kong, Hong Kong SAR, China
EJMO, 025280301 https://doi.org/10.36922/EJMO025280301
Received: 9 July 2025 | Revised: 20 September 2025 | Accepted: 9 October 2025 | Published online: 8 December 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Etomidate is a widely used anesthetic agent. Although its abuse had been reported in scant reports, there has been a recent surge in cases, raising concerns for public safety.

Objective: This review aims to retrospectively analyze case reports of fatal etomidate abuse.

Methods: A literature search on MEDLINE/PubMed, Web of Science, Scopus, the Chinese Biomedical Database, and Google Scholar was conducted. Search terms were developed in relation to the review’s aim, and reports were restricted to the English language.

Results: This review did not identify any published reports of overdose leading to hospital admission and/or treatment. Seven reports of overdose and incidental use were identified and included for evaluation. All cases, except one, occurred in young-to-middle-aged adults, with a dominant male pattern (71%). Three cases occurred in healthcare professionals, and four cases had prior mental illness. Blood concentrations at postmortem and attributed to death ranged from 0.4 to 3.6 μg/mL.

Conclusion: This review identified that ease of access to etomidate among registered healthcare professionals, male gender, young adult age, and history of mental illness were associated with etomidate abuse. However, more research is needed to explore these factors in larger samples. Improved methods to detect and diagnose etomidate misuse are needed to guide clinical and toxicology practices. Active surveillance of misuse is also needed to inform primary and secondary prevention efforts.

Keywords
Etomidate
Fatalities
Abuse
Overdose
Toxicology
Case reports
Healthcare professionals
Substance misuse
Funding
None.
Conflict of interest
The authors declare no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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