Role of target controlled infusion of remifentanil for the prevention of etomidate induced myoclonus during general anesthesia / 中国医学科学院学报

ABSTRACT

<p><b>OBJECTIVE</b>To explore the preventive effect of etomidate-induced myoclonus by different concentrations of target-controlled infusion of remifentanil.</p><p><b>METHODS</b>A total of 120 cases undergoing general anesthesia were randomly divided into 4 groups according to different concentrations of target controlled infusion of remifentanil using plasma target controlled infusion ( Minto model) , in which the target concentration was set as 1 f.Lg/L ( group A) , 2 f.Lg/L ( group B) , 3 f.Lg/L ( group C) , and 4 f.Lg/L ( group D) . Five minutes after the balance of effect compartment, induction with etomidate 0. 3 mglkg was conducted intravenously. The intensity and duration of myoclonus was recorded.</p><p><b>RESULTS</b>The incidence of etomidate-induced myoclonus was 70.9%, 33.3%, 26.7%, and 0 in groups A, B, C, and D, respectively. Along with the increase of the remifentanil concentration, the incidence of severe myoclonus gradually reduced, which was significantly lower in group B and C than in group A ( P < 0. 05). When the concentration reached 4 f.Lg/L, bradycardia and apnea appeared.</p><p><b>CONCLUSION</b>Myoclonus induced by etomidate under general anesthesia can be prevented by target controlled infusion of remifentanil, with 2-3 f.Lg/L being the optimal concentration.</p>