Low-Dose Ketamine Pretreatment Reduces the Incidence and Severity of Myoclonus Induced by Etomidate: A Randomized, Double-Blinded, Controlled Clinical Trial

Medicine (Baltimore). 2016 Feb;95(6):e2701. doi: 10.1097/MD.0000000000002701.

Abstract

Myoclonic movement induced by etomidate is a common but undesirable problem during general anesthesia induction. To investigate the influence of pretreatment with low-dose ketamine on the incidence and severity of myoclonus induced by etomidate, 104 patients were randomized allocated to 1 of 2 equally sized groups (n = 52) to receive either intravenous low-dose ketamine 0.5 mg/kg (group K) or an equal volume of normal saline (group S) 1 minute before induction of anesthesia with 0.3-mg/kg etomidate. The incidence and severity of myoclonus were assessed for 2 minutes after administration of etomidate. Here, we found that the incidence and intensity of myoclonus were both significantly reduced in low-dose ketamine-treated group compared with saline-treated group. The incidence of adverse effects was low and similar between groups. These results demonstrate that intravenous infusion of low-dose ketamine 0.5 mg/kg 1 minute prior to etomidate administration is effective in relieving etomidate-induced myoclonic movements during general anesthesia induction.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anesthesia, General / adverse effects*
  • Anesthesia, General / methods
  • Anesthetics, Dissociative / administration & dosage*
  • Anesthetics, Dissociative / therapeutic use
  • Anesthetics, Intravenous / administration & dosage
  • Anesthetics, Intravenous / adverse effects*
  • Double-Blind Method
  • Drug Administration Schedule
  • Etomidate / administration & dosage
  • Etomidate / adverse effects*
  • Female
  • Humans
  • Incidence
  • Infusions, Intravenous
  • Ketamine / administration & dosage*
  • Ketamine / therapeutic use
  • Male
  • Middle Aged
  • Myoclonus / chemically induced
  • Myoclonus / diagnosis
  • Myoclonus / epidemiology
  • Myoclonus / prevention & control*
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult

Substances

  • Anesthetics, Dissociative
  • Anesthetics, Intravenous
  • Ketamine
  • Etomidate