[Prevention of myoclonus after etomidate using a priming dose].
OBJECTIVE
To investigate the influence of pretreatment with a low dose of etomidate (priming dose) on the incidence of etomidate-induced myoclonus.


METHODS
Prospective randomized double-blind study.


METHODS
Forty six patients ASA physical status I - II, scheduled for abdominal elective surgery, were allocated randomly to receive either pre-treatment 0.03 mg/kg of etomidate (priming group) or placebo (control group). Sixty-seconds after the pre-treatment was injected, anesthesia was induced with etomidate 0.3 mg/kg and 60 seconds later induction was completed with fentanyl (3 microg/kg) and vecuronium (0.1 mg/kg). The occurrence and intensity of myoclonus were graded clinically by a blinded observer as: 0=no myoclonus, 1=mild myoclonus, 2=moderate myoclonus and 3=severe myoclonus.


METHODS
Fisher test exact for qualitative variable and Student t-test for quantitative variables.


RESULTS
Demographic data and the average dose of etomidate used during the induction were similar in the 2 groups (0.29+/-0.032 mg/kg in the priming group and 0.30+/-0.029 mg/kg in the control group). Twenty patients (87%) in the control group experienced myoclonic movements whereas only 6 patients (26%) in the control group had such movements (P<0,001).


CONCLUSIONS
Pretreatment with etomidate (0.03 mg/kg), given 60 seconds before induction of anesthesia, is effective at reducing etomidate-induced myoclonus, without related side-effect.
Aissaoui
Y
Y
Service d'anesthésiologie, département d'anesthésie réanimation et urgences, hôpital militaire d'instruction des armées Mohammed-V, CHU de Rabat, Morocco. younes.aissaoui@hotmail.com
Belyamani
L
L
El Wali
A
A
Idrissi Hajjouji
S-M
SM
Atmani
M
M
Drissi Kamili
N
N
D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects*; D004311:Double-Blind Method; D005045:Etomidate / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009207:Myoclonus / Q000139:chemically induced* / Q000517:prevention & control*; D011446:Prospective Studies
D018686:Anesthetics, Intravenous; D005045:Etomidate