• Y Aissaoui, L Belyamani, A El Wali, S-M Idrissi Hajjouji, M Atmani, and N Drissi Kamili.
• Service d'anesthésiologie, département d'anesthésie réanimation et urgences, hôpital militaire d'instruction des armées Mohammed-V, CHU de Rabat, Morocco. younes.aissaoui@hotmail.com
• Ann Fr Anesth Reanim. 2006 Oct 1;25(10):1041-5.

ObjectiveTo investigate the influence of pretreatment with a low dose of etomidate (priming dose) on the incidence of etomidate-induced myoclonus.Study DesignProspective randomized double-blind study.MethodsForty six patients ASA physical status I - II, scheduled for abdominal elective surgery, were allocated randomly to receive either pre-treatment 0.03 mg/kg of etomidate (priming group) or placebo (control group). Sixty-seconds after the pre-treatment was injected, anesthesia was induced with etomidate 0.3 mg/kg and 60 seconds later induction was completed with fentanyl (3 microg/kg) and vecuronium (0.1 mg/kg). The occurrence and intensity of myoclonus were graded clinically by a blinded observer as: 0=no myoclonus, 1=mild myoclonus, 2=moderate myoclonus and 3=severe myoclonus.Statistical AnalysisFisher test exact for qualitative variable and Student t-test for quantitative variables.ResultsDemographic data and the average dose of etomidate used during the induction were similar in the 2 groups (0.29+/-0.032 mg/kg in the priming group and 0.30+/-0.029 mg/kg in the control group). Twenty patients (87%) in the control group experienced myoclonic movements whereas only 6 patients (26%) in the control group had such movements (P<0,001).ConclusionPretreatment with etomidate (0.03 mg/kg), given 60 seconds before induction of anesthesia, is effective at reducing etomidate-induced myoclonus, without related side-effect.

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