Effect of Pretreatment of Lignocaine Versus Midazolam in the Prevention of Etomidate Induced Myoclonus

F. Batool, A. Ali, S. Lodhi, J. Zahir
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Abstract

Background: The myoclonus after induction of anesthesia with etomidate can lead to increased risk of regurgitation and aspiration. We conducted this study to compare the effectiveness of midazolam and lidocaine for the prevention of etomidate induced myoclonus. Methodology: This randomized controlled trial was done in the Department of Anesthesiology and Intensive Care, Holy Family Hospital, Rawalpindi from January-June 2015 after approval of hospital ethical committee. Informed consent (written) was taken from 224 patients. Patients were allocated into 2 equal groups randomly with the help of computer-generated numbers. Two minutes after induction with etomidate, Group A got 1 ml of 2% lidocaine, and one ml (1 mg) of midazolam was given to Group B. Myoclonus was evaluated in the following one minute, after which 0.5 mg/kg of succinylcholine was given to the patient to facilitate endotracheal intubation. Time of onset of induction was marked by loss of eyelash reflex. Myoclonus was recorded at 20, 40, and 60 seconds. Drug was found to be effective if there was no myoclonus within one minute of etomidate induction. Analysis of data was done using SPSS 17. Results: Lignocaine was effective in preventing myoclonus in 55.40% of patients and Midazolam prevented it in 69.60%. The variation between the results of the groups was found significant statistically. (P< 0.05) Conclusion: Both midazolam and lignocaine are effective in preventing the occurrence of myoclonus associated with etomidate. However, midazolam is the more effective of the two drugs. Keywords: Etomidate, Lignocaine, Midazolam, Myoclonus  
利多卡因预处理与咪达唑仑对依托咪酯性肌阵挛的预防作用
背景:依托咪酯麻醉诱导后的肌阵挛可导致反流和误吸的风险增加。我们进行这项研究是为了比较咪达唑仑和利多卡因预防依托咪酯诱导的肌阵挛的有效性。方法:本随机对照试验经医院伦理委员会批准,于2015年1 - 6月在拉瓦尔品第圣家医院麻醉与重症监护科进行。获取224例患者的知情同意书(书面)。根据计算机生成的数字,将患者随机分为两组。乙咪酯诱导2分钟后,A组给予2%利多卡因1 ml, b组给予咪达唑仑1 ml (1 mg), 1分钟后评价肌收缩,术后给予琥珀胆碱0.5 mg/kg,便于气管插管。诱导开始的时间以睫毛反射的丧失为标志。肌阵挛在20秒、40秒和60秒时被记录下来。如果依托咪酯诱导1分钟内没有肌阵挛,则发现药物是有效的。数据分析采用SPSS 17软件。结果:利多卡因预防肌阵挛的有效率为55.40%,咪达唑仑预防率为69.60%。两组结果差异有统计学意义。结论:咪达唑仑和利多卡因均能有效预防依托咪酯合并肌阵挛的发生。然而,咪达唑仑是两种药物中更有效的一种。关键词:依托咪酯;利多卡因;咪达唑仑
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35
审稿时长
16 weeks
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