Abstract
The objective of this study was to assess the effects of lidocaine on the incidence and severity of myoclonic movements induced by etomidate. Sixty patients were randomly assigned to receive either 20 mg lidocaine or saline (n = 30, each), 30 s before administration of etomidate (0.3 mg/kg). One minute after etomidate administration we assessed severity of myoclonus. Pretreatment with lidocaine significantly reduced both the incidence and severity of myoclonic movements. As a conclusion, lidocaine is an effective and safe drug to reduce the etomidate-induced myoclonus without significant side effects.
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References
Ruth WJ, Burton JH, Bock AJ. Intravenous etomidate for procedural sedation in emergency department patients. Acad Emerg Med. 2001;8:13–8.
Doenicke AW, Roizen MF, Hoernecke R, Lorenz W, Ostwald P. Solvent for etomidate may cause pain and adverse effects. Br J Anaesth. 1999;83:464–6.
Nyman Y, Von Hofsten K, Palm C, Eksborg S, Lönnquist PA. Etomidate-Lipuro is associated with considerable less injection pain in children compared with propofol with added lidocaine. Br J Anaesth. 2006;97:536–9.
Doenicke A, Roizen MF, Nebauer AE, Kugler A, Beger-Hintzen H. A comparison of two formulations for etomidate, 2-hydroxypropyl-beta-cyclodextrin (HPCD) and propylene glycol. Anesth Analg. 1994;79:933–9.
Kulka PJ, Bremer F, Schüttler J. Anesthesia induction using etomidate in a lipid emulsion. Anaesthetist. 1993;42:205–9.
Schwarzkopf KR, Hueter L, Simon M, Fritz HB. Midazolam pretreatment reduces etomidate-induced myoclonic movements. Anaesth Intensive Care. 2003;31:18–20.
Stockham RJ, Stanley TH, Pace NL, Gillmor S, Groen F, Hilkens P. Fentanyl pretreatment modifies anaesthetic induction with etomidate. Anaesth Intensive Care. 1988;16:171–6.
Hueter L, Schwarzkopf K, Simon M, Bredle D, Fritz H. Pretreatment with sufentanil reduces myoclonus after etomidate. Acta Anaesthesiol Scand. 2003;47:482–4.
Kelsaka E, Karakaya D, Sarihasan B, Baris S. Remifentanil pretreatment reduces myoclonus after etomidate. J Clin Anesth. 2006;18:83–6.
Hüter L, Schereiber T, Guegel M, Schwerzkopf K. Low-dose intravenous midazolam reduces etomidate-induced myoclonus: A prospective, randomized study in patients undergoing elective cardioversion. Anesth Analg. 2007;105:1298–302.
Wagler L, White PF, Kan PB, Rosenthal MH, Feldman D. Inhibition of adrenal steroidogenesis by the anesthetic etomidate. N Engl J Med. 1984;310:1415–21.
Doenicke AW, Roizen MF, Kugler J, Kroll H, Foss J, Ostwald P. Reducing myoclonus after etomidate. Anesthesiology. 1999;90:113–9.
Hwang J-Y, Kim J-H, Oh A-Y, Do SH, Jeon YT, Han SH. A comparison of midazolam with remifentanil for prevention of myoclonic movements following etomidate injection. J Int Med Res. 2008;36:17–22.
Reddy RV, Moorthy SS, Dierdorf SF, Deitch RD Jr, Link L. Excitatory effects and electroencephalographic correlation of etomidate, thiopental, methohexital and propofol. Anesth Analg. 1993;77:1008–11.
Modica PA, Tempelhoff R, White PF. Pro- and anticonvulsant effects of anesthetics (Part II). Anesth Analg. 1990;70:433–44.
Choi JM, Choi IC, Jeong YB, Kim TH, Hahm KD. Pretreatment of rocuronium reduces the frequency and severity of etomidate-induced myoclonus. J Clin Anesth. 2009;20:601–4.
Scott RP, Saunders DA, Norman J. Propofol: clinical strategies for preventing pain of injection. Anaesthesia. 1988;43:492–4.
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Gultop, F., Akkaya, T., Bedirli, N. et al. Lidocaine pretreatment reduces the frequency and severity of myoclonus induced by etomidate. J Anesth 24, 300–302 (2010). https://doi.org/10.1007/s00540-010-0869-6
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DOI: https://doi.org/10.1007/s00540-010-0869-6