B. Vandewiele et al., PROPYLENE-GLYCOL TOXICITY CAUSED BY PROLONGED INFUSION OF ETOMIDATE, Journal of neurosurgical anesthesiology, 7(4), 1995, pp. 259-262
We describe a case of propylene glycol toxicity due to intravenous adm
inistration of etomidate for cerebral protection. A continuous etomida
te infusion was titrated to burst suppression of the electroencephalog
ram during surgical resection of a large intracranial arteriovenous ma
lformation. The etomidate formulation used (Amidate, Abbot) contains e
tomidate 2mg/ml in a 35% propylene glycol vehicle. A total of 5 g/kg o
f the solvent was given during 12 h. Adverse effects of propylene glyc
ol were observed including hyperosmolality with an increased osmolal g
ap, hemolysis, hemoglobinuria, and metabolic acidosis. Normalization o
f these metabolic and ionic alterations occurred after 12 h of discont
inuation of the infusion. The potential toxicity of the solvent should
be considered during long-term administration of etomidate.