title: [Role of target controlled infusion of remifentanil for the prevention of etomidate induced myoclonus during general anesthesia].
abstract: OBJECTIVE
  To explore the preventive effect of etomidate-induced myoclonus by different concentrations of target-controlled infusion of remifentanil.
  
  
  METHODS
  A total of 120 cases undergoing general anesthesia were randomly divided into 4 groups according to different concentrations of target controlled infusion of remifentanil using plasma target controlled infusion ( Minto model) , in which the target concentration was set as 1 f.Lg/L ( group A) , 2 f.Lg/L ( group B) , 3 f.Lg/L ( group C) , and 4 f.Lg/L ( group D) . Five minutes after the balance of effect compartment, induction with etomidate 0. 3 mglkg was conducted intravenously. The intensity and duration of myoclonus was recorded.
  
  
  RESULTS
  The incidence of etomidate-induced myoclonus was 70.9%, 33.3%, 26.7%, and 0 in groups A, B, C, and D, respectively. Along with the increase of the remifentanil concentration, the incidence of severe myoclonus gradually reduced, which was significantly lower in group B and C than in group A ( P < 0. 05). When the concentration reached 4 f.Lg/L, bradycardia and apnea appeared.
  
  
  CONCLUSIONS
  Myoclonus induced by etomidate under general anesthesia can be prevented by target controlled infusion of remifentanil, with 2-3 f.Lg/L being the optimal concentration.
authors.affiliation: Department of Anesthesiology, Cancer Institute and Hospital, CAMS and PUM C, Beijing, China. zouliang2001@yahoo.com.cn
authors.forename: Liang
authors.initials: L
authors.lastname: Zou
authors.forename: Hao
authors.initials: H
authors.lastname: Yuan
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Wang
authors.forename: Zhi-yu
authors.initials: ZY
authors.lastname: Geng
authors.forename: Lei
authors.initials: L
authors.lastname: Xu
authors.forename: Li
authors.initials: L
authors.lastname: Sun
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D005045:Etomidate / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage*; D000077208:Remifentanil
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D005045:Etomidate