INCIDENCE OF MYOCLONUS ON INDUCTION WITH ETOMIDATE AND ETOMIDATE WITH ROCURONIUM AS PRIMING AGENT A COMPARITIVE STUDY

DR.KALUVALA PRASAD RAO; DR. KANITHI GEETA; DR.TANWIN KHAN; DR. PRAVEENA; PROF.DILIP KUMAR KULKARNI; PROF.GOPINATH RAMCHANDRAN

Volume : VI, Issue : VI, June - 2017

INCIDENCE OF MYOCLONUS ON INDUCTION WITH ETOMIDATE AND ETOMIDATE WITH ROCURONIUM AS PRIMING AGENT A COMPARITIVE STUDY

Dr. Kaluvala Prasad Rao, Dr. Kanithi Geeta, Dr. Tanwin Khan, Dr. Praveena, Prof. Dilip Kumar Kulkarni, Prof. Gopinath Ramchandran

Abstract :

BACKGROUND AND AIMS:– The comparative study of etomidate on induction and Etomidate with rocuronium as priming agent during general anesthesia was studied to compare for the following aims:– 1.Incidence of myoclonus. 2.Pre–operative /intra–operative / post–operative hemodynamic changes (HR/BP/MAP). 3.Any incidence of complications. And in turn assess the role and usefulness of etomidate in clinical practice as induction agent in general anesthesia. MATERIAL AND METHODS:– This study was conducted in two groups in 50 trauma patients in the age group of 20–50 years of ASA–1 status who weighed between 40–70kgs and were of height 5�3� to 5�8� after pre loading with 1 liter of ringer lactate. A sterile 16G IV cannula placed on left or right dorsum of hand, etomidate 0.3–0.6mg/kg/ body weight , rocuronium 0.6–0.8 mg/kg/ body weight, glycopyrolate 0.1–0.2mg , fentanyl 1–2 mcg/kg/ body weight, Boyles anesthesia machine, airway equipment and standard monitoring intraoperatively. RESULTS:– Incidence of myoclonus was 100% in group–1 patients where etomidate 0.3–0.6mg/kg/body weight was given prior to rocuronium and nil in group–2 patients, where a priming dose of 5mg of total calculated dose of rocuronium was given before the induction dose of etomidate and followed by injecting the rest of calculated dose of rocuronium. The hemodynamic/cardiovascular stability was good in both the groups on induction and throughout the surgery except for transient rise of HR/BP/MAP in group–1 patients on induction. CONCLUSION:– As hemodynamic stability is seen to be good with etomidate on induction and its main side effect myoclonus can be counteracted with use of priming dose of rocuronium, It is prudent to use etomidate in trauma patients where patients have bled profusely and are unstable hemodynamically being taken up for emergency surgeries.