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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

DOI https://doi.org/10.2147/DDDT.S121979

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Dr Tuo Deng

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

1
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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