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Paper Information

Journal:   ANESTHESIOLOGY AND PAIN MEDICINE   APRIL 2016 , Volume 6 , Number 2; Page(s) 0 To 0.
 
Paper: 

COMPARISON OF THE EFFECTS OF LOW-DOSE MIDAZOLAM, MAGNESIUM SULFATE, REMIFENTANIL AND LOW-DOSE ETOMIDATE ON PREVENTION OF ETOMIDATE-INDUCED MYOCLONUS IN ORTHOPEDIC SURGERIES

 
 
Author(s):  SEDIGHINEJAD ABBAS, NADERI NABI BAHRAM, HAGHIGHI MOHAMMAD, BIAZAR GELAREH*, IMANTALAB VALI, RIMAZ SIAMAK, ZARIDOOST ZAHRA
 
* ANESTHESIOLOGY RESEARCH CENTER, ALZAHRA TEACHING HOSPITAL, GUILAN UNIVERSITY OF MEDICAL SCIENCES (GUMS), RASHT, IRAN
 
Abstract: 

Background: Etomidate is a potent hypnotic agent with several desirable advantages such as providing a stable cardiovascular profile withminimalrespiratory adverse effectsandbetterhemodynamicstabilitycomparedwith other induction agents. Thisdrug is associated, however, with myoclonic movements which is characterized by a sudden, brief muscle contractions as a disturbing side-effect.
Objectives: The present study was designed to compare the effectiveness of low- dose midazolam, magnesium sulfate, remifentanil and low-dose etomidate to suppress etomidate-induced myoclonus in orthopedic surgery.
Patients and Methods: A double-blind clinical trial study was conducted in an academic hospital from September 2014 to August 2015. Two hundred and eighty-four eligible patients, American society of anesthesiologists class I - II, scheduled for elective orthopedic surgery were randomly allocated into four equal groups (n=71). They received premedication with intravenous low-dose midazolam 0.015 mg/kg, magnesium sulfate 30 mg/kg, remifentanil 1
mg/kg and low-dose etomidate 0.03 mg/kg two minutes before induction of anesthesia with 0.3 mg/kg intravenous etomidate. Then the incidence and intensity of myoclonus were evaluated on a scale of 0 - 3; 0=no myoclonus; 1=mild (movement at wrist); 2=moderate (movement at arm only, elbow or shoulder); and 3=severe, generalized response or movement in more than one extremity, within ninety seconds. Any adverse effect due to these premedication agents was recorded.
Results: The incidence and intensity of myoclonus were significantly lower in the low-dose etomidate group. The incidence rates of myoclonus were 51 (71.85%), 61 (85.9%), 30 (42.3%) and 41 (57.7%), and the percentages of patients who experienced grade III of myoclonus were 30 (58.8%), 32 (52.5%), 9 (30%) and 14 (34.1%) in the midazolam, magnesium sulfate, etomidate and remifentanil groups, respectively. The incidence and intensity of myoclonus were significantly lower in the low-dose etomidate group (P=0.0001). No notable adverse effect was detected in our patients during the study period.
Conclusions: Intravenous etomidate 0.03 mg/kg prior to induction can effectively reduce the incidence and severity of myoclonus linked to etomidate.

 
Keyword(s): MIDAZOLAM, MAGNESIUM SULFATE, REMIFENTANIL, ETOMIDATE, PREVENTION, MYOCLONUS
 
 
References: 
 
Citations: 
 
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APA: Copy

SEDIGHINEJAD, A., & NADERI NABI, B., & HAGHIGHI, M., & BIAZAR, G., & IMANTALAB, V., & RIMAZ, S., & ZARIDOOST, Z. (2016). COMPARISON OF THE EFFECTS OF LOW-DOSE MIDAZOLAM, MAGNESIUM SULFATE, REMIFENTANIL AND LOW-DOSE ETOMIDATE ON PREVENTION OF ETOMIDATE-INDUCED MYOCLONUS IN ORTHOPEDIC SURGERIES. ANESTHESIOLOGY AND PAIN MEDICINE, 6(2), 0-0. https://www.sid.ir/en/journal/ViewPaper.aspx?id=509825



Vancouver: Copy

SEDIGHINEJAD ABBAS, NADERI NABI BAHRAM, HAGHIGHI MOHAMMAD, BIAZAR GELAREH, IMANTALAB VALI, RIMAZ SIAMAK, ZARIDOOST ZAHRA. COMPARISON OF THE EFFECTS OF LOW-DOSE MIDAZOLAM, MAGNESIUM SULFATE, REMIFENTANIL AND LOW-DOSE ETOMIDATE ON PREVENTION OF ETOMIDATE-INDUCED MYOCLONUS IN ORTHOPEDIC SURGERIES. ANESTHESIOLOGY AND PAIN MEDICINE. 2016 [cited 2021July28];6(2):0-0. Available from: https://www.sid.ir/en/journal/ViewPaper.aspx?id=509825



IEEE: Copy

SEDIGHINEJAD, A., NADERI NABI, B., HAGHIGHI, M., BIAZAR, G., IMANTALAB, V., RIMAZ, S., ZARIDOOST, Z., 2016. COMPARISON OF THE EFFECTS OF LOW-DOSE MIDAZOLAM, MAGNESIUM SULFATE, REMIFENTANIL AND LOW-DOSE ETOMIDATE ON PREVENTION OF ETOMIDATE-INDUCED MYOCLONUS IN ORTHOPEDIC SURGERIES. ANESTHESIOLOGY AND PAIN MEDICINE, [online] 6(2), pp.0-0. Available: https://www.sid.ir/en/journal/ViewPaper.aspx?id=509825.



 
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