title: A comparison of midazolam with remifentanil for the prevention of myoclonic movements following etomidate injection.
abstract: Etomidate is a popular anaesthetic induction agent, but it frequently causes myoclonic movements. Although both benzodiazepines and opioids reduce myoclonus, there has been no comparative study between these agents. Thus, we conducted a prospective, randomized study to compare midazolam and remifentanil as pre-treatment agents for reducing etomidate-induced myoclonus in 90 adults undergoing surgery. Patients were pre-treated before the etomidate injection, either with saline (Group C), midazolam 0.5 mg/kg (Group M) or remifentanil 1 microg/kg (Group R). Both Groups M and R showed a significantly lower incidence of myoclonus compared with Group C (17%, 17% and 77%, respectively). The incidence of myoclonus was not significantly different between Groups M and R, but 10% (n = 10) of the patients in Group R experienced remifentanil-related side-effects. We conclude that midazolam is probably a better choice than remifentanil for reducing etomidate-induced myoclonus during anaesthesia induction.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Bundang Hospital, Seoul National University, Bundang-gu, Gyeonggi-do, Korea.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Hwang
authors.forename: J-H
authors.initials: JH
authors.lastname: Kim
authors.forename: A-Y
authors.initials: AY
authors.lastname: Oh
authors.forename: S-H
authors.initials: SH
authors.lastname: Do
authors.forename: Y-T
authors.initials: YT
authors.lastname: Jeon
authors.forename: S-H
authors.initials: SH
authors.lastname: Han
mesh_terms: D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000037:antagonists & inhibitors*; D004311:Double-Blind Method; D005045:Etomidate / Q000009:adverse effects / Q000819:agonists*; D006801:Humans; D015994:Incidence; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D010880:Piperidines / Q000627:therapeutic use*; D000077208:Remifentanil; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D008874:Midazolam; D005045:Etomidate