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Effect of dexmedetomidine in preventing etomidate-induced myoclonus: a meta-analysis

Authors Du X, Zhou C, Pan L, Li C

Received 9 September 2016

Accepted for publication 5 January 2017

Published 8 February 2017 Volume 2017:11 Pages 365—370


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Tuo Deng

Xueke Du,1 Chengmao Zhou,2 Linghui Pan,1 Changlong Li1

Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 2Department of Surgery, Zhaoqing Medical College, Zhaoqing Shi, Guangdong Sheng, People’s Republic of China

Objective: To investigate the effect of dexmedetomidine in the prevention of etomidate-induced myoclonus.
Methods: We searched for randomized controlled trials (RCTs) regarding the use of dexmedetomidine in preventing etomidate-induced myoclonus in the databases PubMed, EMBASE, the Cochrane Library, and CNKI. We extracted data and assessed the quality of the literature and adopted RevMan 5.2 to conduct meta-analysis on each effective index and employed funnel plot to test publication bias.
Results: The results showed that the incidence of etomidate-induced myoclonus in the dexmedetomidine treated groups was significantly lower than that of the control groups (risk ratio [RR]=0.27, 95% confidence interval [CI] [0.15, 0.47], P<0.00001). With regard to the severity of etomidate-induced myoclonus, incidences of etomidate-induced myoclonus in the dexmedetomidine treated groups resulting in mild myoclonus (RR=0.37, 95% CI [0.19, 0.75], P=0.006), moderate myoclonus (RR=0.21, 95% CI [0.12, 0.37], P<0.00001), or severe myoclonus (RR=0.18, 95% CI [0.08, 0.38], P<0.00001) were significantly lower than those of the control groups. No statistically significant difference was found (RR=0.70, 95% CI [0.47, 1.04], P=0.08) between etomidate-induced myoclonus in the dexmedetomidine treated groups and that of the midazolam treated groups.
Conclusion: Dexmedetomidine can effectively prevent the incidence of etomidate-induced myoclonus and reduce the severity of etomidate-induced myoclonus. In addition, there were no significant differences between the effects of dexmedetomidine and midazolam in preventing etomidate-induced myoclonus.

Keywords: dexmedetomidine, myoclonus-chemically induced, etomidate, meta-analysis

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