• Jinfeng Liu, Rongfang Liu, Chao Meng, Zhenhua Cai, Xiaoqi Dai, Chao Deng, Jiahang Zhang, and Huacheng Zhou.
• Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, and the Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin Affiliate Hospital of HeBei University Department of Anesthesiology, Affiliate Hospital of HeBei University, No.212 of Yuhua East Road, Baoding Department of Anesthesiology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, China.
• Medicine (Baltimore). 2017 Jun 1; 96 (26): e7212.

ObjectiveMyoclonus, a common complication during intravenous induction with etomidate, is bothersome to both anesthesiologists and patients. This study explored the preventive effect of pretreatment with propofol on etomidate-related myoclonus.MethodsThis was a prospective, double-blind, clinical, randomized controlled study. Totally, 363 patients who were scheduled for a short-duration, painless gastrointestinal endoscopy were divided into 5 groups. Four groups received 0 mg/kg (E group), 0.25 mg/kg (LPE group), 0.50 mg/kg (MPE group), or 0.75 mg/kg (HPE group) propofol pretreatment before etomidate anesthesia. Another group only received 1 to 2 mg/kg of propofol (P group) as anesthesia. The incidence and severity of myoclonus, patient circulation and respiratory status, and intraoperative and postoperative complications were recorded.ResultsThe incidence of myoclonus in the LPE group (26.8%), MPE group (16.4%), HPE group (14.9%), and P group (0) was lower than the E group (48.6%, P < .05). The incidence of grade 1, 2, and 3 of myoclonus in the LPE group, MPE group, HPE group, and P group was significantly lower than the E group, and that in the P group was lower than the LPE group (P < .05). The incidence of hypoxemia in the P group was higher than the E group, and the incidence of adverse events in the HPE group and P group was lower than the E group (P < .05).DiscussionPretreatment with propofol was feasible for preventing etomidate-related myoclonus. Furthermore, as propofol dosage increased, its effect on reducing the incidence and severity of myoclonic movements induced by etomidate increased.

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