Efficacy of Granisetron versus Sufentanil on Reducing Myoclonic Movements Following Etomidate: A double-blind, randomized clinical trial

Abstract

Objective: Etomidate-induced myoclonus occurs in up to 85% of patients under general anesthesia. This type of myoclonus can induce significant clinical and economic problems in patients with special conditions. Hence, to reduce the intensity of myoclonus movements, the present study was conducted to compare the effectiveness of granisetron and sufentanil on reducing the intensity of etomidate-induced myoclonic movements. Methods: This double-blind randomized clinical trial study consisted of 96 adult patients. Using block randomization, subjects were divided into three groups of 32: the group receiving granisetron 40 μg / kg (group G), the group receiving sufentanil 0.2 μg / kg (group S), and the control group who did not receive the pretreatment (group C). Patients received these medications as pretreatments 120 seconds before induction with etomidate. After injection of etomidate with a dose of 0.3 mg/kg, the incidence of myoclonus was evaluated. After evaluating the myoclonus, the full dose of narcotics (fentanyl 1 μg / kg) and muscle relaxants (atracurium 0.5 mg/kg) were administered to patients, and a suitable airway was established for them. Results: The findings indicated that granisetron reduced the intensity and incidence of myoclonic movements more than sufentanil. In addition, myoclonic movements were observed at a significantly higher intensity in the control group (P=0.001). Conclusion: The results obtained from the current study indicate that granisetron and sufentanil as pretreatments are effective for reducing myoclonus in patients.

Keywords: Granisetron; Sufentanil; Etomidate; Myoclonus; Movement.