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Effect of dexmedetomidine on etomidate-induced myoclonus: a randomized, double-blind controlled trial

Authors Miao S, Zou L, Wang G, Wang X, Liu S, Shi M

Received 28 December 2018

Accepted for publication 25 March 2019

Published 27 May 2019 Volume 2019:13 Pages 1803—1808


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Sukesh Voruganti

Shuai Miao,1,2 Lan Zou,1,2 Guanglei Wang,1,2 Xiuli Wang,1,2 Su Liu,1,2 Mengzhu Shi1,2

1Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, People’s Republic of China; 2Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of China

Background: Etomidate used for the induction of general anesthesia can result in myoclonus. We tested the hypothesis that pretreatment with dexmedetomidine (Dex) reduces the incidence of etomidate-induced myoclonus during the induction of general anesthesia.
Materials and methods: One hundred patients who were scheduled for selective operations under general anesthesia were included in this randomized, double-blind controlled trial. Patients were randomized to receive either Dex 0.5 μg/kg in 20 mL of normal saline or the same volume of normal saline as pretreatment agents 15 mins before the injection of etomidate 0.3 mg/kg. The primary endpoint was the incidence of etomidate-induced myoclonus. Secondary endpoints were the severity of etomidate-induced myoclonus and the incidence of adverse effects from the onset of action of Dex or normal saline to the injection of etomidate, such as dizziness, respiratory depression, bradycardia, hypotension and nausea/vomiting.
Results: All of the 100 patients completed the trial. Dex resulted in a significant 38% reduction in the number of patients who experienced etomidate-induced myoclonus: 13 (26%) vs 32 (64%) (P=0.0001). Additionally, the severity of myoclonus was also reduced in the Dex group than that in the placebo group (P=0.02). Incidence of dizziness, respiratory depression, bradycardia, hypotension and nausea/vomiting was similar in both groups.
Conclusions: Pretreatment with Dex 0.5 μg/kg 15 mins before the induction of general anesthesia not only resulted in a 38% reduction in the incidence of etomidate-induced myoclonus, but also reduced the severity of myoclonus, without inducing any adverse effects.

Keywords: general anesthesia, adverse effects, myoclonus

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