Prevention of etomidate-induced myoclonus during anesthetic induction by pretreatment with dexmedetomidine.

Abstract

Myoclonus induced by etomidate during induction of general anesthesia is undesirable. This study evaluated the effect of dexmedetomidine (DEX) pretreatment on the incidence and severity of etomidate-induced myoclonus. Ninety patients undergoing elective surgical procedures were randomly allocated to three groups (n=30 each) for intravenous administration of 10 mL isotonic saline (group I), 0.5 µg/kg DEX in 10 mL isotonic saline (group II), or 1.0 µg/kg DEX in 10 mL isotonic saline (group III) over 10 min. All groups subsequently received 0.3 mg/kg etomidate by intravenous push injection. The incidence and severity of myoclonus were recorded for 1 min after etomidate administration and the incidence of cardiovascular adverse events that occurred between the administration of the DEX infusion and 1 min after tracheal intubation was recorded. The incidence of myoclonus was significantly reduced in groups II and III (30.0 and 36.7%), compared with group I (63.3%). The incidence of severe sinus bradycardia was significantly increased in group III compared with group I (P<0.05), but there was no significant difference in heart rate in groups I and II. There were no significant differences in the incidence of low blood pressure among the 3 groups. Pretreatment with 0.5 and 1.0 µg/kg DEX significantly reduced the incidence of etomidate-induced myoclonus during anesthetic induction; however, 0.5 µg/kg DEX is recommended because it had fewer side effects.

• Authors: H F Luan, Z B Zhao, J Y Feng, J Z Cui, X B Zhang, P Zhu, Y H Zhang
• Journal: Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas (Braz J Med Biol Res) Vol. 48 Issue 2 Pg. 186-90 (Feb 2015) ISSN: 1414-431X [Electronic] Brazil
• PMID: 25351237 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anesthetics, General
• Hypnotics and Sedatives
• Dexmedetomidine
• Etomidate

Topics

• Adult
• Anesthetics, General (adverse effects)
• Blood Pressure (drug effects)
• Bradycardia (epidemiology)
• Dexmedetomidine (administration & dosage)
• Elective Surgical Procedures
• Etomidate (adverse effects)
• Female
• Heart Rate (drug effects)
• Humans
• Hypnotics and Sedatives (administration & dosage)
• Incidence
• Male
• Middle Aged
• Myoclonus (chemically induced, epidemiology, prevention & control)
• Severity of Illness Index
• Treatment Outcome