Remimazolam Pretreatment Reduces Etomidate-Induced Myoclonus in Gastroscopy: A Randomized Controlled Trial
نویسندگان
1 Basic Medical Science, Hebei University, Baoding, China, 071000
2 Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding, China, 071000
3 Department of Anesthesiology, Sixth People's Hospital of Hengshui, Hengshui, China, 053200
4 Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding, China, 071000
5 Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding, China, 071000
6 Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding, China, 071000
7 Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding, China, 071000
8 Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding, China, 071000
9 Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding, China, 071000
10 Baoding Food and Drug Inspection Institute, Baoding, China, 071000
11 Department of Thoracic Surgery, Affiliated Hospital of Hebei University, Baoding, China, 071000
doi
10.22034/ircmj.2025.509813.1948چکیده
Background and Objectives: Myoclonus, caused by etomidate during general anesthesia induction, can lead to serious complications. Objectives: To determine how remimazolam pretreatment influences reduction in the incidence and severity of etomidate-related myoclonus. Methods: In this randomized controlled trial, 216 patients were assigned to 4 groups. Prior to etomidate induction, three groups received pretreatment with remimazolam at 0, 0.025, and 0.05 mg/kg doses (E, LRE, and HRE groups, respectively). The fourth group was anesthetized with 0.2 mg/kg remimazolam alone (R group). The primary outcome was myoclonus incidence and severity. Complications were also documented. The chi-square test/Fisher’s exact test and two-way analysis of variance were used for the corresponding data. Results: Myoclonus frequency was lower in the LRE group (14/50, 28%), the HRE group (8/51, 16%), and the R group (0/51, 0%) than in the E group (28/52, 54%); myoclonus incidence showed a similar trend (P<0.001). Additionally, the HRE group performed better than the LRE group (P<0.001). Compared to the E group, the HRE, LRE, and R groups exhibited significantly lower incidence of intraoperative and postoperative complications (P=0.001); moreover, the HRE and LRE groups showed no significant difference in intraoperative and postoperative complications, while the R group had a lower incidence of complications than the HRE and LRE groups (P<0.001). Conclusion: Remimazolam pretreatment was feasible to prevent etomidate-associated myoclonus during gastroscopy. Remimazolam shows more efficacy at 0.05 mg/kg dose than at 0.025 mg/kg dose.
