Remifentanil pretreatment reduces myoclonus after etomidate

Study Objective: The aim of the study was to compare the effect of pretreatment with remifentanil 1 mu g/kg and the effect of gender on the incidence of myoclonus after anesthesia induction with etomidate. Design: This was a randomized, double-blind study. Setting: The study was conducted at a university hospital. Patients: Sixty patients were pretreated in a randomized double-blinded fashion with remifentanil 1 mu g/kg or placebo. Two minutes after remifentanil or placebo injection, etomidate 0.3 mg/kg was given. Measurements: Myoclonus was recorded with a scale of 0 to 3. The grade of sedation (none, mild, moderate, severe), nausea, pruritis, and apnea were recorded after injection of both drugs. Main Results: The incidence of myoclonus was significantly lower in the remifentanil group (6.7%) than in the placebo group (70%) (P < 0.001). None of the patients experienced sedation, apnea, nausea, or prurtis after injection of both drugs. In the placebo group, male patients were associated with significantly increased incidence of myoclonus after etomidate administration. Conclusion: Pretreatment with remifentanil 1 mu g/kg reduced myoclonus after etomidate induction without side effects such as sedation, apnea, nausea, or pruritis. Men experience increased incidence of myoclonus than women after etomidate administration. (c) 2006 Elsevier Inc. All rights reserved.