A comparison of pretreatment with lignocaine versus dexmedetomidine in prevention of etomidate induced myoclonus- A randomised comparative trial

Abstract

Etomidate is a short-acting non-barbiturate intravenous anesthetic with rapid induction and rapid awakening. It is frequently utilized in clinical practice, especially for patients with an unstable cardiovascular system, due to its minimal influence on hemodynamics and respiratory depression. However, Etomidate might cause side effects during anaesthetic induction, such as injection discomfort, phlebitis, hemolysis, and myoclonus. This study was, therefore, conducted in order to compare the pre-treatment with lignocaine versus dexmedetomidine in deterrence of myoclonus resulting from Etomidate.60 patients were allocated randomly into two study groups. Each group comprising 30 patients. Patients in GroupI received injection Lignocaine (1 mg/kg)and Group II received injection Dexmedetomidine (0.5μg/kg) in 10 ml of normal saline over 10 min followed by Etomidate injection (0.3 mg/kg) over 30 s. Patients were observed for 2 minutes for occurrence of myoclonus and the intensity and time of occurrence was noted by a person blinded to the drug used.In our study, 90% patients were myoclonus grade zero, followed by 6.7%, 3.3% and no one of myoclonus grade one, two and three in dexmedetomidine group at 1 min. 60.0%, 10.0%, 13.3% and 16.7% patients had grade zero, one, two, three of myoclonus respectively in lignocaine group at 1 min. 80.0% patients were myoclonus grade zero, followed by 13.3%, 3.3%, 3.3% of patients had myoclonus grade one, two, three respectively in dexmedetomidine group at 2mins. 53.3%, 10.0%, 16.7%, 20.0% patients were myoclonus grade zero, one, two and three respectively in lignocaine group at 2mins. On the whole 46.7% patients in lignocaine group developed Myoclonus; but 20.0% in dexmedetomidine group shows the myoclonus.We conclude that the prevalence of Etomidate-induced myoclonus was significantly decreased in patients who were pre-treated with dexmedetomidine in comparison with lignocaine.