Remifentanil pretreatment reduces myoclonus after etomidate

Abstract

Study Objective The aim of the study was to compare the effect of pretreatment with remifentanil 1 μg/kg and the effect of gender on the incidence of myoclonus after anesthesia induction with etomidate. Design This was a randomized, double-blind study. Setting The study was conducted at a university hospital. Patients Sixty patients were pretreated in a randomized double-blinded fashion with remifentanil 1 μg/kg or placebo. Two minutes after remifentanil or placebo injection, etomidate 0.3 mg/kg was given. Measurements Myoclonus was recorded with a scale of 0 to 3. The grade of sedation (none, mild, moderate, severe), nausea, pruritis, and apnea were recorded after injection of both drugs. Main Results The incidence of myoclonus was significantly lower in the remifentanil group (6.7%) than in the placebo group (70%) ( P < 0.001). None of the patients experienced sedation, apnea, nausea, or pruritis after injection of both drugs. In the placebo group, male patients were associated with significantly increased incidence of myoclonus after etomidate administration. Conclusion Pretreatment with remifentanil 1 μg/kg reduced myoclonus after etomidate induction without side effects such as sedation, apnea, nausea, or pruritis. Men experience increased incidence of myoclonus than women after etomidate administration.