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.
RCT Entities:
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.