@article{He_Ding_Chen_Qian_Li_2014, title={Butorphanol pre-treatment prevents myoclonus induced by etomidate}, volume={144}, url={https://smw.ch/index.php/smw/article/view/3261}, DOI={10.4414/smw.2014.14042}, abstractNote={<p id="12e54b9830fff1aaab0a6aa311581c3d117abf02" class="abstract">QUESTIONS UNDER STUDY: Myoclonic movements are common problems during induction of anaesthesia with etomidate. The myoclonus occurring after etomidate administration may represent a form of seizure. Agonistic modulation of the κ opiate receptor may reduce seizures, and butorphanol acts in such a manner. The aim of this randomised, double-blind, placebo-controlled clinical trial was to test our hypothesis that pre-treatment with butorphanol might reduce the incidence and severity of myoclonus induced by etomidate.</p> <p id="872328139440d238c6d700cdc303727fe53bfa15" class="abstract">METHODS: Patients (108) with American Society of Anaesthesiologists physical status I or II were randomly assigned to one of two groups to receive either 0.015 mg/kgof butorphanol (n = 54) or saline (n = 54) intravenously. At two minutes after infusion of butorphanol or saline, 0.3 mg/kg etomidate was given. The occurrence and severity (observational score of 0–3) of myoclonus was assessed during 2 minutes after administration of etomidate. For each patient, blood pressure (BP), saturation of peripheral oxygen (SpO<sub>2</sub>), and heart rate (HR) were measured.</p> <p id="cf7b4582543aaccdd6ac1c57db93ec6bec242458" class="abstract">RESULTS: The incidence of myoclonus was significantly lower in Group Butorphanol than in Group Saline (13.0% vs 79.6%; RR = 0.163, 95%CI: 0.081–0.329; χ<sup>2</sup>= 48.265, <em>p</em> <0.0001). The severity levels of myoclonic movement were also significantly lower in Group Butorphanol than in Group Saline (<em>p</em> <0.0001). Throughout the procedure, changes of BP, SpO<sub>2</sub>, and HR did not differ between the groups. There were no problems with bradycardia or hypotension.</p> <p id="3263f0b53e87ff696cbadeeff1d99d462f725519" class="abstract">CONCLUSIONS: Infusion of 0.015 mg/kgbutorphanol 2 minutes before etomidate administration is effective for suppressing myoclonus induced by etomidate during induction of general anaesthesia.</p>}, number={4142}, journal={Swiss Medical Weekly}, author={He, Liang and Ding, Ying and Chen, Huiyu and Qian, Yanning and Li, Zhong}, year={2014}, month={Oct.}, pages={w14042} }