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Etomidate induced myoclonus for procedural sedation in emergency department

Publisher : Journal of Pharmaceutical Sciences and Research

Year : 2017

Abstract : Aim: We analyse the incidence of myoclonus in patients whom Etomidate is used for procedural sedation in the Emergency Room. According to previous studies, the incidence rate of Etomidate induced myoclonus is 33%. Methods: This prospective study was performed between June 2016 to December 2016 in the Emergency Department of Amrita Institute of Medical Sciences, a tertiary care hospital. Etomidate was used for procedural sedation was carried out by the Emergency Physician. The presence of myoclonus was noticed and its duration was reported using the Myoclonus scale. Results: 166 patients (116Males and 50Females) in the Emergency Department in whom Etomidate was used for procedural sedation were enrolled for the study. The mean age was observed to be 42 years among males and females. The mean cumulative dose was 0.3mg/kg. Premedication was not used, which increases the chance of detection of myoclonus. Full recovery to the preprocedural level of alertness was achieved within 30 mins in 160 (96%) of procedures. Mean changes in Systolic blood pressure, pulse rate and oxygen saturation were clinically insignificant. Myoclonus was observed in 4 (2.4%) of 166 patients which is significantly lower than the earlier studies. Conclusion: Etomidate is a useful agent for carefully conducted procedural sedation because it provides effective, brief, deep sedation with little hemodynamic compromise. Myoclonus is seen only small percentage of patients and can be safely used for procedural sedation in the Emergency Room. © 2017, Pharmainfo Publications. All rights reserved.

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