A Comparision of Two Different Doses of Butorphanol-Pretreatment to Establish A Minimum Effective Dose for Etomidate Induced Myoclonus - A Prospective Randomized Study
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 3
Abstract
Introduction: Etomidate is often used for induction of general anaesthesia because of its very stable hemodynamic profile. myoclonus is common problem with induction of anaesthesia with etomidate, which may be a problem in non fasting patients, open eye injury and epileptic patients. Incidence of myoclonus shown to be reduced by variety of opioid agents. Butorphanol is strong analgesic with both narcotic agonistic and antagonistic properties. This prospective randomized study was aimed to compare two different doses of butorphanol to establish minimum effective dose for prevention of myoclonus. Material and methods: A total of 90 patients,ASA I and II undergoing elective surgery were randomized into three groups comprising of 30 patients each. Group B and Group C received butorphanol 0.04 mg/kg and 0.02 mg/kg respectively and group A received normal saline. Two minutes after pretreatment patients received etomidate 0.3 mg /kg. Assessment of myoclonus after etomidate was done using four point scale:0= no myoclonus, 1 = mild myoclonus, 2= moderate myoclonus and 3= severe myoclonus. Results: The incidence of myoclonus in Group A is 76.67% and Group B and Group C is 3.3% and 10% respectively. The difference among Group A to Group B and Group C is highly significant (P < 0.001) and Group B and Group C is statistically insignificant (P =0.296).The difference in severity of myoclonus in Group A in compared to Group B and C is statistically significant(p< 0.001) and between Group B and C is insignificant((P=0.552). Conclusion: Butorphanol 0.02 mg/kg is as effective as 0.04 mg/kg in reducing etomidate induced myoclonus.
Authors and Affiliations
Rashmi Pal, Parul Jain, K. K. Arora, Bharathi B
Keywords
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