Comparison between Fentanyl and Nalbuphine Pretreatment in Prevention of Etomidate Induced Myoclonus
Creators
- 1. Senior Resident Department of Anesthesia, SSB Shyam Shah Medical College, Rewa, Madhya Pradesh
- 2. Senior Registrar in Apollo Hospital, Jubilee Hills, Hyderabad, Telangana
Description
Background: Etomidate is a cardio stable intra vascular induction agent associated with myoclonus, a frequent and dangerous side effect of etomidate induction, and many opioids have been studied for effectively attenuating etomidate induced myoclonus. But there is no evident literature comparing the efficacy of nalbuphine and fentanyl pretreatment on Etomidate induced myoclonus, this study was engineered to compare efficacy of 0.2mg/kg nalbuphine and 2mcg/kg fentanyl intravenous pretreatment for myoclonus prevention caused by Etomidate. Aims: Aim of this study is to compare the efficacy fentanyl with nalbuphine in prevention of etomidate induced myoclonus. Material and Methods: This prospective randomized double blind placebo controlled study was conducted in a tertiary hospital associated with a medical college, 60 patients undergoing elective surgeries under general anaesthesia were randomly allocated to one of the two groups 2mcg/kg of fentanyl in 10ml of normal saline(group I) or 0.2mg/kg of nalbuphine in 10ml of normal saline(group II) 150 seconds before injecting iv Etomidate 0.3mg/kg administered over 20 seconds, patients were assessed for severity of myoclonus associated with etomidate induction over next two minutes. Students t test, chi-square test were used as per the requirement and a P value of <0.05 was considered statistically significant. Result: Out of 60 patients 30 were pretreated with fentanyl and 30 were pretreated with nalbuphine prior to etomidate induction. In our study 14(46.62%) patients from fentanyl group developed myoclonus whereas only 6(20%) patients from nalbuphine group developed myoclonus, 4(13.32%) patients from fentanyl group had pain on injection whereas only 2(6.66%) patients from nalbuphine group had pain on injection, 6(19.98%) patients from fentanyl group developed minor side effects like bradycardia 2(6.66%), hypotension 2(6.66%), nausea vomiting 1(3.33%), sedation 1(3.33%) whereas in nalbuphine group 8(26.64%) patients developed minor side effects like bradycardia 3(9.99%), hypotension 2(6.66%), nausea vomiting 2(6.66%), sedation 1(3.33%). Conclusion: Both groups were comparable with respect to demographic characteristics, the incidence(46.62% in group I vs. 20% in group II) and severity(0.4 in group I vs 0.8 in group II), of myoclonus was significantly reduced in nalbuphine pretreatment group compared to fentanyl group, whereas the safety profile of both the groups was comparable with no significant side effects; (95% confidence interval, P < 0.05).
Abstract (English)
Background: Etomidate is a cardio stable intra vascular induction agent associated with myoclonus, a frequent and dangerous side effect of etomidate induction, and many opioids have been studied for effectively attenuating etomidate induced myoclonus. But there is no evident literature comparing the efficacy of nalbuphine and fentanyl pretreatment on Etomidate induced myoclonus, this study was engineered to compare efficacy of 0.2mg/kg nalbuphine and 2mcg/kg fentanyl intravenous pretreatment for myoclonus prevention caused by Etomidate. Aims: Aim of this study is to compare the efficacy fentanyl with nalbuphine in prevention of etomidate induced myoclonus. Material and Methods: This prospective randomized double blind placebo controlled study was conducted in a tertiary hospital associated with a medical college, 60 patients undergoing elective surgeries under general anaesthesia were randomly allocated to one of the two groups 2mcg/kg of fentanyl in 10ml of normal saline(group I) or 0.2mg/kg of nalbuphine in 10ml of normal saline(group II) 150 seconds before injecting iv Etomidate 0.3mg/kg administered over 20 seconds, patients were assessed for severity of myoclonus associated with etomidate induction over next two minutes. Students t test, chi-square test were used as per the requirement and a P value of <0.05 was considered statistically significant. Result: Out of 60 patients 30 were pretreated with fentanyl and 30 were pretreated with nalbuphine prior to etomidate induction. In our study 14(46.62%) patients from fentanyl group developed myoclonus whereas only 6(20%) patients from nalbuphine group developed myoclonus, 4(13.32%) patients from fentanyl group had pain on injection whereas only 2(6.66%) patients from nalbuphine group had pain on injection, 6(19.98%) patients from fentanyl group developed minor side effects like bradycardia 2(6.66%), hypotension 2(6.66%), nausea vomiting 1(3.33%), sedation 1(3.33%) whereas in nalbuphine group 8(26.64%) patients developed minor side effects like bradycardia 3(9.99%), hypotension 2(6.66%), nausea vomiting 2(6.66%), sedation 1(3.33%). Conclusion: Both groups were comparable with respect to demographic characteristics, the incidence(46.62% in group I vs. 20% in group II) and severity(0.4 in group I vs 0.8 in group II), of myoclonus was significantly reduced in nalbuphine pretreatment group compared to fentanyl group, whereas the safety profile of both the groups was comparable with no significant side effects; (95% confidence interval, P < 0.05).
Files
IJPCR,Vol15,Issue4,Article152.pdf
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Additional details
Dates
- Accepted
-
2023-04-15
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue4,Article152.pdf
- Development Status
- Active
References
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