title: Prevention of etomidate-induced myoclonus during anesthetic induction by pretreatment with dexmedetomidine.
abstract: Myoclonus induced by etomidate during induction of general anesthesia is undesirable. This study evaluated the effect of dexmedetomidine (DEX) pretreatment on the incidence and severity of etomidate-induced myoclonus. Ninety patients undergoing elective surgical procedures were randomly allocated to three groups (n=30 each) for intravenous administration of 10 mL isotonic saline (group I), 0.5 µg/kg DEX in 10 mL isotonic saline (group II), or 1.0 µg/kg DEX in 10 mL isotonic saline (group III) over 10 min. All groups subsequently received 0.3 mg/kg etomidate by intravenous push injection. The incidence and severity of myoclonus were recorded for 1 min after etomidate administration and the incidence of cardiovascular adverse events that occurred between the administration of the DEX infusion and 1 min after tracheal intubation was recorded. The incidence of myoclonus was significantly reduced in groups II and III (30.0 and 36.7%), compared with group I (63.3%). The incidence of severe sinus bradycardia was significantly increased in group III compared with group I (P<0.05), but there was no significant difference in heart rate in groups I and II. There were no significant differences in the incidence of low blood pressure among the 3 groups. Pretreatment with 0.5 and 1.0 µg/kg DEX significantly reduced the incidence of etomidate-induced myoclonus during anesthetic induction; however, 0.5 µg/kg DEX is recommended because it had fewer side effects.
authors.affiliation: Department of Anesthesia, The First People's Hospital of Lianyungang, China.
authors.forename: H F
authors.initials: HF
authors.lastname: Luan
authors.affiliation: Department of Anesthesia, The First People's Hospital of Lianyungang, China.
authors.forename: Z B
authors.initials: ZB
authors.lastname: Zhao
authors.affiliation: Department of Anesthesia, The First People's Hospital of Lianyungang, China.
authors.forename: J Y
authors.initials: JY
authors.lastname: Feng
authors.affiliation: Department of Anesthesia, The First People's Hospital of Lianyungang, China.
authors.forename: J Z
authors.initials: JZ
authors.lastname: Cui
authors.affiliation: Department of Anesthesia, The First People's Hospital of Lianyungang, China.
authors.forename: X B
authors.initials: XB
authors.lastname: Zhang
authors.affiliation: Department of Anesthesia, The First People's Hospital of Lianyungang, China.
authors.forename: P
authors.initials: P
authors.lastname: Zhu
authors.affiliation: Department of Anesthesia, The First People's Hospital of Lianyungang, China.
authors.forename: Y H
authors.initials: YH
authors.lastname: Zhang
mesh_terms: D000328:Adult; D018681:Anesthetics, General / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D001919:Bradycardia / Q000453:epidemiology*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D017558:Elective Surgical Procedures; D005045:Etomidate / Q000009:adverse effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018681:Anesthetics, General; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D005045:Etomidate