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.
SUPPLEMENTARY MATERIAL Part I: HPLC method detailsGraceSmart (RP-18, 250 × 4.6 mm, 5 µm, USA) reverse phase C18 column equipped with UV detector at 263 nm was used. Mobile phase (1 ml/min flow rate) consist of a mixture of acetonitrile: 5% v/v glacial acetic acid in de-ionized water (20:80, v/v, 3.4 pH).
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