Journal of clinical anesthesia · 2008
Pretreatment of rocuronium reduces the frequency and severity of etomidate-induced myoclonus.
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Choi Jae Moon, Choi In Cheol, Jeong Yong Bo, Kim Tae Hee, Hahm Kyung Don
Аннотация
STUDY OBJECTIVE: To investigate the effect of pretreatment with a low dose of rocuronium on the occurrence of etomidate-induced myoclonus.
DESIGN: Prospective, randomized, double-blinded study.
SETTING: Medical center in South Korea.
PATIENTS: 110 ASA physical status I, II, and III patients scheduled for elective cardiac or pulmonary surgery with general anesthesia.
INTERVENTIONS: All patients were randomized to pretreatment with a low dose of rocuronium (0.06 mg/kg; Group R) or placebo (saline; Group S), followed three minutes later by etomidate (0.3 mg/kg).
MEASUREMENTS: Patients were monitored for myoclonic movements and pain on a scale of 0-3. Bispectral index (BIS) and electromyographic (EMG) activity were recorded continuously throughout the procedure.
MAIN RESULTS: Frequency of myoclonus was significantly lower in Group R (25%) than in Group S (63%). In the latter group, there was no difference in the frequency of male (59%) and female (68%) patients experiencing myoclonus. In Group S, EMG activity and BIS were significantly increased in patients who experienced severe myoclonus, and BIS was well correlated with EMG activity.
CONCLUSIONS: Pretreatment with a small dose of rocuronium before induction of anesthesia with etomidate significantly reduced the frequency of myoclonus.
DESIGN: Prospective, randomized, double-blinded study.
SETTING: Medical center in South Korea.
PATIENTS: 110 ASA physical status I, II, and III patients scheduled for elective cardiac or pulmonary surgery with general anesthesia.
INTERVENTIONS: All patients were randomized to pretreatment with a low dose of rocuronium (0.06 mg/kg; Group R) or placebo (saline; Group S), followed three minutes later by etomidate (0.3 mg/kg).
MEASUREMENTS: Patients were monitored for myoclonic movements and pain on a scale of 0-3. Bispectral index (BIS) and electromyographic (EMG) activity were recorded continuously throughout the procedure.
MAIN RESULTS: Frequency of myoclonus was significantly lower in Group R (25%) than in Group S (63%). In the latter group, there was no difference in the frequency of male (59%) and female (68%) patients experiencing myoclonus. In Group S, EMG activity and BIS were significantly increased in patients who experienced severe myoclonus, and BIS was well correlated with EMG activity.
CONCLUSIONS: Pretreatment with a small dose of rocuronium before induction of anesthesia with etomidate significantly reduced the frequency of myoclonus.
Предметные рубрики MeSH
AdultAgedAndrostanolsAnesthetics, IntravenousCardiac Surgical ProceduresDouble-Blind MethodElectromyographyEtomidateFemaleHumansKoreaMaleMiddle AgedMonitoring, IntraoperativeMyoclonusNeuromuscular Nondepolarizing AgentsProspective StudiesPulmonary Surgical ProceduresRocuroniumSeverity of Illness Index