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A comparison of fentanyl and dexamethasone pretreatment for prevention of etomidate induced myoclonus, a randomized double blind placebo controlled study

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Original Article

Author Details : Neha Mehra, Robina Makker*, Abhishek Khanna

Volume : 7, Issue : 3, Year : 2020

Article Page : 432-437

https://doi.org/10.18231/j.ijca.2020.079

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Abstract

Background and Aims: Etomidate is used for induction of anaesthesia in haemodynamically unstable
patients but its use is associated with undesirable side effects like myoclonus, incidence of which is 50-
80%. This prospective, randomized, placebo controlled study is to compare the effect of dexamethasone
and fentanyl for prevention of etomidate induced myoclonus.
Materials and Methods: Ninety adult patients were randomly assigned into three groups to receive
Dexamethasone (group D), Fentanyl (group F) and placebo (group P) five min before injection etomidate
0.3mg/kg IV. The patients were assessed for myoclonus using a four point intensity scoring system over a
period of 5 min. ANOVA and chi square test were used for statistical analysis and P<0> as statistically significant.
Results: The incidence of myoclonus was significantly reduced in groups D and F compared with group P
(p value 0.001).The incidence of pain associated with Etomidate induced myoclonus also was significantly
reduced in groups D and F compared to group P (p value 0.001).
Conclusion: Dexamethasone significantly reduces the incidence of myoclonus as compared to placebo. It
also significantly reduces the pain associated with Etomidate injection. However its efficacy to reduce pain
and myoclonus as compared to Fentanyl is much less.

Keywords: Etomidate, Myoclonus, Dexamethasone.

How to cite : Mehra N , Makker R , Khanna A, A comparison of fentanyl and dexamethasone pretreatment for prevention of etomidate induced myoclonus, a randomized double blind placebo controlled study. Indian J Clin Anaesth 2020;7(3):432-437

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