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CYP11B1 is a key enzyme in glucocorticoid synthesis necessary for the conversion of 11-deoxycortisol to cortisol and 11-deoxycorticosterone to corticosterone ( Regarding the timing of the effects of etomidate, a single dose of etomidate given before surgery usually results in a return to baseline levels of the inhibited enzymes by 24 hours after anesthesia induction, while continuous use leads to an inhibitory effect lasting longer than 24 hours, with possibly dose-dependency ( Conclusion Our analysis of the two case reports revealed that both patients had been using electronic cigarettes containing etomidate for several months