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Using dezocine to prevent etomidate-induced myoclonus: a meta-analysis of randomized trials

Authors Zhu Y, Yang Y, Zhou C, Bao Z

Received 19 March 2017

Accepted for publication 15 May 2017

Published 18 July 2017 Volume 2017:11 Pages 2163—2170

DOI https://doi.org/10.2147/DDDT.S137464

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Salvatore Bongarzone

Peer reviewer comments 3

Editor who approved publication: Professor Manfred Ogris

Yu Zhu,1,* Yuting Yang,2,* Chengmao Zhou,3 Zeqing Bao4

1Department of Nursing, Zhaoqing Medical College, 2Department of Oncology, the First People’s Hospital of Changde, 3Department of Anesthesiology, Zhaoqing Medical College, 4Department of Basic Medicine, Zhaoqing Medical College, Changde, China

*These authors contributed equally to this work

Objective: This study was designed to evaluate the efficacy and safety of preinjection of dezocine in preventing etomidate-induced myoclonus.
Methods: PubMed, Embase, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched to collect relevant randomized controlled trials (RCTs) from inception to July 2016 on the preinjection of dezocine in preventing etomidate-induced myoclonus. Two researchers independently screened literature, extracted data, and evaluated bias risks in accordance with inclusion and exclusion criteria, and then used RevMan 5.2 to perform the meta-analysis.
Results: A total of six RCTs were included in this study. The meta-analysis showed that 1) the preinjection of dezocine can reduce the incidence of etomidate-induced myoclonus (relative risk [RR] =0.25, 95% CI [0.13, 0.50], P<0.0001), which is consistent with the result of subgroup analysis; 2) the preinjection of dezocine can reduce the incidence of mild, moderate, and severe myoclonus; 3) dezocine was not related to an increasing incidence of etomidate-induced dizziness and nausea (RR =2.83, 95% CI [0.66, 12.08], P=0.6); and 4) dezocine did not reduce heart rates after the administration of etomidate (mean difference =1.06, 95% CI [–4.08, 6.19], P=0.69).
Conclusion: The preinjection of dezocine has the effect of both lowering the incidence of etomidate-induced myoclonus and easing the severity of myoclonus, but without increasing dizziness and nausea or affecting the heart rate.

Keywords: dezocine, etomidate, myoclonus, meta-analysis, RCTs

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