title: Pretreatment of rocuronium reduces the frequency and severity of etomidate-induced myoclonus.
abstract: OBJECTIVE
  To investigate the effect of pretreatment with a low dose of rocuronium on the occurrence of etomidate-induced myoclonus.
  
  
  METHODS
  Prospective, randomized, double-blinded study.
  
  
  METHODS
  Medical center in South Korea.
  
  
  METHODS
  110 ASA physical status I, II, and III patients scheduled for elective cardiac or pulmonary surgery with general anesthesia.
  
  
  METHODS
  All patients were randomized to pretreatment with a low dose of rocuronium (0.06 mg/kg; Group R) or placebo (saline; Group S), followed three minutes later by etomidate (0.3 mg/kg).
  
  
  METHODS
  Patients were monitored for myoclonic movements and pain on a scale of 0-3. Bispectral index (BIS) and electromyographic (EMG) activity were recorded continuously throughout the procedure.
  
  
  RESULTS
  Frequency of myoclonus was significantly lower in Group R (25%) than in Group S (63%). In the latter group, there was no difference in the frequency of male (59%) and female (68%) patients experiencing myoclonus. In Group S, EMG activity and BIS were significantly increased in patients who experienced severe myoclonus, and BIS was well correlated with EMG activity.
  
  
  CONCLUSIONS
  Pretreatment with a small dose of rocuronium before induction of anesthesia with etomidate significantly reduced the frequency of myoclonus.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
authors.forename: Jae Moon
authors.initials: JM
authors.lastname: Choi
authors.forename: In Cheol
authors.initials: IC
authors.lastname: Choi
authors.forename: Yong Bo
authors.initials: YB
authors.lastname: Jeong
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Kim
authors.forename: Kyung Don
authors.initials: KD
authors.lastname: Hahm
mesh_terms: D000328:Adult; D000368:Aged; D000732:Androstanols / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures / Q000379:methods; D004311:Double-Blind Method; D004576:Electromyography; D005045:Etomidate / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009207:Myoclonus / Q000139:chemically induced / Q000517:prevention & control*; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use; D011446:Prospective Studies; D013510:Pulmonary Surgical Procedures / Q000379:methods; D000077123:Rocuronium; D012720:Severity of Illness Index
chemical_list: D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium; D005045:Etomidate