The proper effect site concentration of remifentanil for prevention of myoclonus after etomidate injection

Korean Journal of Anesthesiology

Sang Wook Shin¹  Seung Wan Baik¹  Tae Kyun Kim¹  Hyun Su Ri¹  Ji Uk Yoon¹  Gyeong Jo Byeon¹ 

[1] Department of Anesthesiology and Pain Medicine, Pusan National University School of Medicine, Yangsan, Korea.;

关键词: etomidate;    myoclonus;    remifentanil;   

DOI  :  10.4097/kjae.2011.61.2.127

来源: DOAJ

【 摘 要 】

BackgroundEtomidate frequently induces myoclonus when administered intravenously with bolus injection during anesthetic induction. This can be bothersome for the anesthesiologist. The dose of remifentanil appropriate for preventing myoclonus without side effects was investigated.MethodsAll patients with American Society of Anesthesiologists (ASA) physical status I-III were divided into three groups (n = 33 per group) according to the pretreatment effect site concentration of remifentanil (Ultiva, Glaxo-Wellcome, München, Germany) of 0, 2 or 4 ng/ml (Group N: 0 ng/ml, Group R: 2 ng/ml, Group Q: 4 ng/ml) by a target controlled infusion (TCI) system. After a 0.3 mg/kg dose of etomidate was injected intravenously for over 1 minute for anesthetic induction, myoclonus was observed. Before the etomidate injection, the patients were pretreated with remifentanil and their side effects were monitored.ResultsThe number of patients showing myoclonus was significantly different among the groups. The incidence of myoclonus was 81%, 12% and 0% (groups N, R, and Q, respectively, P < 0.01). Side effects including bradycardia and hypotension did not occur in either Group R or Q. Chest wall rigidity occured in 45% of patients in Group Q.ConclusionsAdministration with a 2 ng/ml effect site concentration of remifentanil could reduce the incidence of myoclonus caused by etomidate bolus injection without chest wall rigidity.

【 授权许可】

Unknown