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Comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study
BACKGROUND AND AIMS: Etomidate is a popular induction agent, but its use is associated with myoclonus in 50%–80% of non-premedicated patients. This study aims to compare dexmedetomidine and butorphanol for their relative efficacy in preventing etomidate-induced myoclonus. METHODS: This randomised st...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566664/ https://www.ncbi.nlm.nih.gov/pubmed/37829775 http://dx.doi.org/10.4103/ija.ija_414_23 |
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author | Rautela, Rajesh S. Gulabani, Michell Kumar, Pramod Salhotra, Rashmi Mohta, Medha Verma, Kshitiz |
author_facet | Rautela, Rajesh S. Gulabani, Michell Kumar, Pramod Salhotra, Rashmi Mohta, Medha Verma, Kshitiz |
author_sort | Rautela, Rajesh S. |
collection | PubMed |
description | BACKGROUND AND AIMS: Etomidate is a popular induction agent, but its use is associated with myoclonus in 50%–80% of non-premedicated patients. This study aims to compare dexmedetomidine and butorphanol for their relative efficacy in preventing etomidate-induced myoclonus. METHODS: This randomised study was conducted after obtaining institutional ethical committee clearance and written informed consent from sixty American Society of Anesthesiologists (ASA) I or II consenting patients between 18 and 60 years of age of either sex who had been scheduled for elective surgeries under general anaesthesia. Patients were randomly allocated to dexmedetomidine 0.5 μg/kg (Group D) or butorphanol 0.015 mg/kg (Group B). Both the drugs were given as an infusion over a period of 10 min before induction of anaesthesia. The primary outcome was the incidence of myoclonic movements after etomidate, and the secondary outcomes were the severity of myoclonus, changes in the haemodynamic parameters and incidence of airway complications. Normally distributed variables were compared using Student’s t-test, and non-normally distributed variables were compared using Mann–Whitney U test. Qualitative data were analysed using Chi-square/Fisher’s exact test. A P-value <0.05 was considered significant. RESULTS: The incidence of etomidate-induced myoclonus was significantly higher in group B compared to group D (P = 0.035). The median (interquartile range [IQR]) of myoclonus grade in patients of group D was 0.00 (0.00–3.00), and group B was 2.50 (0.00–3.00) (P = 0.035). Haemodynamics and airway-related complications were comparable between the groups. CONCLUSION: Dexmedetomidine was more effective than butorphanol in preventing etomidate-induced myoclonus. |
format | Online Article Text |
id | pubmed-10566664 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-105666642023-10-12 Comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study Rautela, Rajesh S. Gulabani, Michell Kumar, Pramod Salhotra, Rashmi Mohta, Medha Verma, Kshitiz Indian J Anaesth Original Article BACKGROUND AND AIMS: Etomidate is a popular induction agent, but its use is associated with myoclonus in 50%–80% of non-premedicated patients. This study aims to compare dexmedetomidine and butorphanol for their relative efficacy in preventing etomidate-induced myoclonus. METHODS: This randomised study was conducted after obtaining institutional ethical committee clearance and written informed consent from sixty American Society of Anesthesiologists (ASA) I or II consenting patients between 18 and 60 years of age of either sex who had been scheduled for elective surgeries under general anaesthesia. Patients were randomly allocated to dexmedetomidine 0.5 μg/kg (Group D) or butorphanol 0.015 mg/kg (Group B). Both the drugs were given as an infusion over a period of 10 min before induction of anaesthesia. The primary outcome was the incidence of myoclonic movements after etomidate, and the secondary outcomes were the severity of myoclonus, changes in the haemodynamic parameters and incidence of airway complications. Normally distributed variables were compared using Student’s t-test, and non-normally distributed variables were compared using Mann–Whitney U test. Qualitative data were analysed using Chi-square/Fisher’s exact test. A P-value <0.05 was considered significant. RESULTS: The incidence of etomidate-induced myoclonus was significantly higher in group B compared to group D (P = 0.035). The median (interquartile range [IQR]) of myoclonus grade in patients of group D was 0.00 (0.00–3.00), and group B was 2.50 (0.00–3.00) (P = 0.035). Haemodynamics and airway-related complications were comparable between the groups. CONCLUSION: Dexmedetomidine was more effective than butorphanol in preventing etomidate-induced myoclonus. Wolters Kluwer - Medknow 2023-09 2023-09-06 /pmc/articles/PMC10566664/ /pubmed/37829775 http://dx.doi.org/10.4103/ija.ija_414_23 Text en Copyright: © 2023 Indian Journal of Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Rautela, Rajesh S. Gulabani, Michell Kumar, Pramod Salhotra, Rashmi Mohta, Medha Verma, Kshitiz Comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study |
title | Comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study |
title_full | Comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study |
title_fullStr | Comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study |
title_full_unstemmed | Comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study |
title_short | Comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study |
title_sort | comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: a double-blind, randomised controlled study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566664/ https://www.ncbi.nlm.nih.gov/pubmed/37829775 http://dx.doi.org/10.4103/ija.ija_414_23 |
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