Efficacy of lignocaine versus midazolam in controlling etomidate-induced myoclonus : a randomizedplacebo-controlled

Abstract EN

Background Etomidate has many desirable properties like rapid onset of profound hypnosis, short duration, hemodynamic stability, and minimal respiratory depression.

Few side effects such as myoclonus, reduced cortisol secretion, and pain on injection abate its regular use.

Aim The aim of this study was to evaluate the effect of pretreatment with lignocaine and midazolam on the incidence and severity of myoclonus due to etomidate.

Materials and methods A prospective, randomized, double-blind, placebo-controlled study was conducted on 75 patients with American Society of Anesthesiology physical status I or II, undergoing general anesthesia for various elective surgical procedures.

Patients were divided into three groups each comprising 25 patients: group I received 1 ml of normal saline, group II received 1 ml of 2% lignocaine and group III received 1 ml of midazolam (1 mg) as premedication 2 min before induction with 0.3 mg/kg etomidate.

Myoclonus was assessed and graded on a four-point scale.

Statistical data analysis Results were compiled and statistically analyzed using the χ2-test for nonparametric data and analysis of variance test for parametric data.

For all statistical analysis, P less than 0.05 was considered statistically signifi cant.

Results The incidence of myoclonus in control group was 76%, whereas patients premedicated with midazolam or lignocaine showed 28 and 44% incidence, respectively.

The severity of myoclonus was also decreased in both midazolam and lignocaine groups.

The incidence of other side effects among the groups was similar (P > 0.05).

Conclusion Premedication with both lignocaine and midazolam was effective in reducing the incidence and severity of myoclonus.