Midazolam Pre-Treatment before Etomidate Anaesthesia
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 4
Abstract
Introduction: Etomidate a GABA receptor stimulating hypnotic agent is short-acting, has minimal residual sedation and a favourable haemodynamic profile and is thus a common choice for short term procedures especially in the haemodynamically compromised patients. But it has undesirable side effects of pain on injection and myoclonus. The problem of pain on injection has been solved by a new lipid formulation for etomidate. Myoclonus is seen in up to 50 to 80% of patients during induction of anaesthesia with etomidate if no supplemental agents are used. A number of drugs have been investigated for the suppression of etomidate-induced myoclonus. Ideally a pre-treatment drug for preventing myoclonic movements should be short acting, not have significant effects on respiration and haemodynamics and not prolong recovery from anaesthesia. Etomidate has a less inhibitory effect on the pharyngo-laryngeal reflex, hence blunting the responses to laryngoscopy and endotracheal intubation is also necessary. Materials and Methods: This study was conducted to study the effect of pre-treatment with midazolam on etomidate induced myoclonus.We studied 30 patients who were given Midazolam pre-treatment before administration of Etomidate. Results: 23.33% (7/30) patients developed myoclonus and none of them had severe myoclonus. Vital were not significantly affected. Conclusion: Midazolam is a good pre-treatment option before etomidate as it reduces incidence and severity of etomidate induced myoclonus without significant adverse effects.
Authors and Affiliations
Neha Goyal
Keywords
Related Articles
- EP ID EP622215
- DOI 10.21088/ijaa.2349.8471.6419.18
- Views 78
- Downloads 0
Comparative Study of Intravenous Ondansetron and Dexamethasone for Amelioration of Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy
Background: Postoperative nausea and vomiting (PONV) is considered most unpleasant experience by the patients in postoperative period. In particular, following laparoscopic procedures the incidence of PONV is very high....
A Comparative Study of Hemodynamic Response and Ease of Intubation in Patients Intubated by Direct Laryngoscopy Versus Lightwand
Introduction: Direct laryngoscopic endotracheal intubation is associated with varying degrees of sympathetic activity which may be detrimental in patients with coexisting conditions, such as coronary artery disease, elev...
A Randomized Clinical Trail to Compare Palonosetron and Ondansetron for Prevention of Post Operative Nausea and Vomiting
Abstract: Nausea and vomiting is known to be associated with the use of anaesthetic technique for many years. Ondansetron a gold standard drug used for treatment of post operative nausea and vomiting (PONV) is short acti...
Evaluation of Low Dose Bupivacaine with Clonidine for Unilateral Spinal Anesthesia in Lower Limb Surgeries
Introduction: Unilateral spinal anaesthesia has been extensively studied for short duration elective lower limb surgeries with favorable results i.e when block is desired on operative side only with absence of block on n...
Comparison of Oral Pregabalin Versus Bolus Dose of Intravenous Dexmedetomidine in Attenuating the Hemodynamic responses During Laparoscopic Cholecystectomy: A Prospective Randomized double Blind Study
Background and Aims: Laparoscopic cholecystectomy is being preferred surgery for gall bladder diseases under general anesthesia in the present era. This study was designed to compare oral pregabalin versus intravenous de...