Paradoxical Agitation Following Etomidate Sedation for Electrical Cardioversion: A Case Report

Etomidate is commonly used for procedural sedation in the emergency department due to its rapid onset, short duration of action, and favorable hemodynamic profile. Adverse effects are generally limited to pain at the injection site, myoclonus, nausea, and transient adrenal suppression. Paradoxical agitation following etomidate administration is rarely described. We report a case of severe, transient agitation following low-dose etomidate used for procedural sedation to facilitate electrical cardioversion in a healthy young adult presenting with new-onset atrial fibrillation.