Effectiveness of Midazolam in the Prevention of Etomidate Induced Myoclonus

Zafar, Bushra

doi:10.4172/2155-6148.1000503

Cited by 1 publication

(1 citation statement)

References 13 publications

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“…It was shown that myoclonus occurred at a significantly lower rate in patients who received a bolus pre-treatment dose followed by a therapeutic dose (11). Also, Salim et al showed that the intensity of myoclonus was higher in patients not receiving pre-treatment than in the other two groups but no significant difference was observed between the two groups receiving etomidate pre-treatment (20). In our study, we tried an initial bolus dose of pre-treatment, but did not study the bolus and infusion administration of the drug.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Premedication with Low-Dose Midazolam Versus Etomidate for Reduction of Etomidate-Induced Myoclonus During General Anesthesia for Electroconvulsive Therapy: A Randomized Clinical Trial

Nazemroaya

Mousavi

2019

Anesth Pain Med

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Background: A variety of anesthetics including methohexital, thiopental sodium, propofol, ketamine, and etomidate are used for electroconvulsive therapy (ECT), each accompanied by adverse effects that can cause unpleasant experiences for patients. Etomidateinduced myoclonus is among the adverse effects. We attempted to assess the effect of premedication with low-dose midazolam compared to etomidate on the reduction of this complication. Objectives: This study was designed to compare the effectiveness of low-dose etomidate and low-dose midazolam to suppress etomidate-induced myoclonus in ECT. Methods: This randomized double-blinded clinical trial was conducted on 132 patients who were candidates for ECT. They were divided into three groups of 44 patients to receive 0.015 mg/kg midazolam, 0.03 mg/kg etomidate, or placebo. Independent t-test and chi-square test were used for comparison of variables. Results: The frequency of myoclonic movements during anesthesia was different between the three groups (P value < 0.001). Myoclonic movements were significantly lower in the midazolam group than in the placebo (P value < 0.001) and etomidate (P value = 0.002) groups. In addition, the intensity of myoclonic movements was significantly higher in the midazolam group than in the placebo and etomidate groups (P value < 0.001). Conclusions: Low-dose midazolam (0.015 mg/kg) before anesthesia induction with etomidate was accompanied with significantly lower incidence and intensity of myoclonus than low-dose etomidate (0.03 mg/kg).

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Section: Discussionmentioning

confidence: 99%