title: Low-dose intravenous midazolam reduces etomidate-induced myoclonus: a prospective, randomized study in patients undergoing elective cardioversion.
abstract: BACKGROUND
  Myoclonic movements are a common problem in unpremedicated patients during induction of anesthesia with etomidate.
  
  
  METHODS
  In a double-blind fashion, 40 patients (ASA physical status III-IV) scheduled for elective cardioversion were randomly assigned to receive either 0.015 mg/kg midazolam or placebo 90 s before the injection of 0.3 mg/kg etomidate. Myoclonic movements and sedation were recorded on a scale between 0 and 3. Pulse oximetry, noninvasive arterial blood pressure, and heart rate were recorded during the study period.
  
  
  RESULTS
  Two patients (10%) in the midazolam group had myoclonic movements after the administration of etomidate, whereas 10 of the 20 patients (50%) receiving placebo experienced such movements (P = 0.006). No other differences were found between the groups; in particular, there was no difference in recovery 5 min after the administration of etomidate.
  
  
  CONCLUSIONS
  IV midazolam 0.015 mg/kg administered 90 s before induction of anesthesia with etomidate is effective in reducing myoclonic movements and does not prolong recovery in unpremedicated patients after short procedures.
authors.affiliation: Klinik für Anästhesiologie und Intensivtherapie, Friedrich-Schiller-Universität Jena, Germany. lars.hueter@med.uni-jena.de
authors.forename: Lars
authors.initials: L
authors.lastname: Hüter
authors.forename: Torsten
authors.initials: T
authors.lastname: Schreiber
authors.forename: Michael
authors.initials: M
authors.lastname: Gugel
authors.forename: Konrad
authors.initials: K
authors.lastname: Schwarzkopf
mesh_terms: D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D004311:Double-Blind Method; D004554:Electric Countershock / Q000379:methods; D005045:Etomidate / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D018686:Anesthetics, Intravenous; D008874:Midazolam; D005045:Etomidate