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A comparison of midazolam and dexmedetomidine for the prevention of myoclonic movements and pain following etomidate injection

By Aktolga S., Gunes Y., Gunduz M. and Isik G.

Abstract

Background: Etomidate may cause injection pain and myoclonus during the anaesthesia induction. Both benzodiazepines and opioids reduce myoclonus, however so far dexmedetomidine has not been studied for the same. We designed a study to investigate the effects of pretreatment with IV midazolam or dexmedetomidine on the incidence and severity of myoclonus and injection pain during induction of anaesthesia with etomidate. Patients & Methods: 152 patients were pre-treated before the etomidate injection, either with saline (Group P, n= 51) or midazolam 0.5 mg/kg (Group M, n=51) or dexmedetomidine 1 microg/kg (Group D, n=50). Results: Both Groups M and D showed a significantly lower incidence of myoclonus compared with Group P. Within 60 s after induction with etomidate, 19 (37%) of 51 patients in the midazolam group, 15 (30%) of 50 patients in the dexmedetomidine group and 46 (90%) of 51 patients in the placebo group developed myoclonic movements. Also, within 60 s after induction with etomidate, 1 (2%) of 51 patients in the midazolam group, 3 (6%) of 50 patients in the dexmedetomidine group and 43(6%) of 51 patients (85%) in the placebo group developed injection pain after the etomidate induction. Conclusion: We conclude that either dexmedetomidine or midazolam administered before etomidate induction reduces myoclonic muscle movements and injection pain during anaesthesia induction without any haemodynamic side effects

Topics: Dexmedetomidine, Midazolam, Myoclonic and pain, Premediction, Prevention
Year: 2010
OAI identifier: oai:openaccess.cu.edu.tr:20.500.12605/10006
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