Pretreatment with sufentanil reduces myoclonus after etomidate.
BACKGROUND
Myoclonic movements are a common problem during the induction of general anesthesia with etomidate. We investigated the influence of pretreatment with the opioid sufentanil on the incidence of etomidate-induced myoclonus.


METHODS
Forty female patients (ASA physical status I-III) were randomly assigned to receive double-blinded either 0.3 micro g kg-1 of sufentanil or placebo 150 s before the induction of sleep with 0.3 mg kg-1 of etomidate. The patients were observed for any myoclonic movement. Grade of dizziness, breathing frequency, non-invasive blood pressure and heart rate were measured during the study period.


RESULTS
None of the 20 patients receiving sufentanil had myoclonic movements after the administration of etomidate, whereas 16 patients in the placebo group (80%) experienced such movements (P<0.01). No cases of apnoea before induction of sleep were seen in the sufentanil group.


CONCLUSIONS
Sufentanil 0.3 micro g kg-1 is an effective and safe drug to reduce myoclonus after etomidate without causing any harmful side-effect.
Hueter
L
L
Klinik fuer Anesthesiologie und Intensivtherapie, Friedrich-Schiller-Universitaet Jena, Germany. lars.hueter@med.uni-jena.de
Schwarzkopf
K
K
Simon
M
M
Bredle
D
D
Fritz
H
H
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D004311:Double-Blind Method; D005045:Etomidate / Q000009:adverse effects*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced* / Q000517:prevention & control*; D011229:Preanesthetic Medication; D017409:Sufentanil / Q000008:administration & dosage*
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D017409:Sufentanil; D005045:Etomidate