Dexmedetomidine combining midazolam in reducing incidence of etomidate myoclonus

Abstract

Objective To observe the clinical effect of dexmedetomidine combining midazolam on reducing the incidence of etomidate myoclonus. Methods 240 cases of gynecological laparoscopic operation from our hospital in 2016 were randomly divided into 3 groups (80 for each group): group A (control group) intravenously injected etomidate 0.30 mg/kg, cisatracurium 0.20 mg/kg, and sufentanil 0.50 μg/kg in sequence; group B (mixed group) intravenously injected midazolam 0.05 mg/kg, sufentanil 0.10 μg/kg, cisatracurium 0.05 mg/kg,etomidate 0.30 mg/kg,cisatracurium 0.15 mg/kg, and sufentanil 0.40 μg/kg in sequence;and group C (dexmedetomidine group) firstly pumped dexmedetomidine 0.50 μg/kg,then were given midazolam 0.05 mg/kg,and the rest was the same as group A.The incidence of myoclonus 2 min after the intravenous injection of etomidate and the changes of NIBp, HR, and SpO2 before and after administration were observed and recorded. Results There were no statistical differences in the changes of NIBp and SpO2 in the 3 groups between before and after administration (all P>0.05). The HR was lower in group C than in group A after administration(P<0.05). The incidence of myoclonus was 2.50% in group C, 68.75% in group A, and 11.25% in group B (P<0.05). Conclusions Dexmedetomidine combining midazolam can effectively avoid the myoclonus caused by etomidate. It can provide some clinical references for anesthesia induction by etomidate. Key words: Dxmedetomidine; Midazolam; Etomidate; Myoclonus