Prévention des myoclonies induites par l'étomidate en utilisant une priming dose

Aissaoui, Y.; Belyamani, Lahcen; Wali, Ashutosh; Hajjouji, S.-M. Idrissi; Atmani, M.; Kamili, N. Drissi

doi:10.1016/j.annfar.2006.07.079

Cited by 16 publications

(15 citation statements)

References 11 publications

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“…There was no significant difference in the incidence of EIM between the control and slow injection groups. The incidence of 84.1% (53/63 patients) EIM in the control group in our study is comparable to the results of other studies [ 2 , 10 ]. Aissaoui et al [ 2 ] observed a significant reduction in the incidence of EIM following pretreatment with a low dose of etomidate (priming dose).…”

Section: Discussionsupporting

confidence: 91%

“…The incidence of 84.1% (53/63 patients) EIM in the control group in our study is comparable to the results of other studies [ 2 , 10 ]. Aissaoui et al [ 2 ] observed a significant reduction in the incidence of EIM following pretreatment with a low dose of etomidate (priming dose). In their study, 26% (6/23 patients) of patients in the priming group experienced myoclonus as compared to 87% (20/23 patients) in the control group (P < 0.001).…”

Section: Discussionsupporting

confidence: 91%

“…A change in the etomidate injection technique can itself reduce the incidence of EIM, eliminating the need for an additional drug with its inherent cost and potential side effects [ 2 , 4 ]. Pre-treatment with a low dose of etomidate (priming dose) [ 2 ] and slow injection of the induction dose [ 4 ] have both been shown to reduce the incidence of EIM. To the best of our knowledge, however, there are no studies comparing these two techniques, and therefore it is not clear which is the better option.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of priming versus slow injection for reducing etomidate-induced myoclonus: a randomized controlled study

Mullick

Talwar

et al. 2018

Korean J Anesthesiol

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BackgroundEtomidate injection is often associated with myoclonus. Etomidate injection technique influences the incidence of myoclonus. This study was designed to clarify which of the two injection techniques—slow injection or priming with etomidate—is more effective in reducing myoclonus.MethodsThis prospective randomized controlled study was conducted on 189 surgical patients allocated to three study groups. Control group (Group C, n = 63) received 0.3 mg/kg etomidate (induction dose) over 20 s. Priming group (Group P, n = 63) received pretreatment with 0.03 mg/kg etomidate, followed after 1 min by an etomidate induction dose over 20 s. Slow injection group (Group S, n = 63) received etomidate (2 mg/ml) induction dose over 2 min. The patients were observed for occurrence and severity of myoclonus for 3 min from the start of injection of the induction dose.ResultsThe incidence of myoclonus in Group P (38/63 [60.3%], 95% CI: 48.0–71.5) was significantly lower than in Group C (53/63 [84.1%], 95% CI: 72.9–91.3, P = 0.003) and Group S (49/63 [77.8%], 95% CI: 66.0–86.4, P = 0.034). Myoclonus of moderate or severe grade occurred in significantly more patients in Group C (68.3%) than in Group P (36.5%, P < 0.001) and Group S (50.8%, P = 0.046), but the difference between Groups P and S was not significant (P = 0.106).ConclusionsPriming is more effective than slow injection in reducing the incidence of myoclonus, but their effects on the severity of myoclonus are comparable.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of priming versus slow injection for reducing etomidate-induced myoclonus: a randomized controlled study

Mullick

Talwar

et al. 2018

Korean J Anesthesiol

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“…[10] Thus, etomidate itself and low-dose propofol might be the ideal drugs for pretreatment. Aissaoui et al [35] found that pretreatment with a low dose (0.03 mg/kg) of etomidate at 60 seconds before induction with etomidate could effectively inhibit the development of myoclonus. In this study, we demonstrated that propofol pretreatment inhibited myoclonus induced by etomidate, and the pretreatment had no severe related side effects.…”

Section: Discussionmentioning

confidence: 99%

Propofol decreases etomidate-related myoclonus in gastroscopy

Liu

Meng

et al. 2017

Medicine

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Objective:Myoclonus, a common complication during intravenous induction with etomidate, is bothersome to both anesthesiologists and patients. This study explored the preventive effect of pretreatment with propofol on etomidate-related myoclonus.Methods:This was a prospective, double-blind, clinical, randomized controlled study. Totally, 363 patients who were scheduled for a short-duration, painless gastrointestinal endoscopy were divided into 5 groups. Four groups received 0 mg/kg (E group), 0.25 mg/kg (LPE group), 0.50 mg/kg (MPE group), or 0.75 mg/kg (HPE group) propofol pretreatment before etomidate anesthesia. Another group only received 1 to 2 mg/kg of propofol (P group) as anesthesia. The incidence and severity of myoclonus, patient circulation and respiratory status, and intraoperative and postoperative complications were recorded.Results:The incidence of myoclonus in the LPE group (26.8%), MPE group (16.4%), HPE group (14.9%), and P group (0) was lower than the E group (48.6%, P < .05). The incidence of grade 1, 2, and 3 of myoclonus in the LPE group, MPE group, HPE group, and P group was significantly lower than the E group, and that in the P group was lower than the LPE group (P < .05). The incidence of hypoxemia in the P group was higher than the E group, and the incidence of adverse events in the HPE group and P group was lower than the E group (P < .05).Discussion:Pretreatment with propofol was feasible for preventing etomidate-related myoclonus. Furthermore, as propofol dosage increased, its effect on reducing the incidence and severity of myoclonic movements induced by etomidate increased.

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“…In a previous study, NMDA-gated currents were reduced by thiopental sodium in the PFC pyramidal neurons, which may reduce the excitability of the PFC. Neural transmission mediated by the other transmitters in both the PFC and the other brain regions may be influenced by thiopental sodium [14]. The effectiveness of pretreatment with thiopental in myoclonic activity has not been previously investigated.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment with Dexmedetomidine or Thiopental Decreases Myoclonus after Etomidate: A Randomized, Double-Blind Controlled Trial

Mızrak¹,

Koruk²,

Bilgi³

et al. 2010

Journal of Surgical Research

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Prévention des myoclonies induites par l'étomidate en utilisant une priming dose

Cited by 16 publications

References 11 publications

Comparison of priming versus slow injection for reducing etomidate-induced myoclonus: a randomized controlled study

Comparison of priming versus slow injection for reducing etomidate-induced myoclonus: a randomized controlled study

Propofol decreases etomidate-related myoclonus in gastroscopy

Pretreatment with Dexmedetomidine or Thiopental Decreases Myoclonus after Etomidate: A Randomized, Double-Blind Controlled Trial

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