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
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- EP ID EP622215
- DOI 10.21088/ijaa.2349.8471.6419.18
- Views 96
- Downloads 0
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