Research on Etomidate Complications Observed during Induction

Ahn, Won sik; Kim, Dong uk

Abstract

BACKGROUND: The properties of etomidate include hemodynamic stability, minimal respiratory depression, cerebral protection, and rapid recovery. However, its drawbacks include temporary inhibition of steroid synthesis, pain on injection, thrombophlebitis, myoclonus, nausea and vomiting. This study was done to discover the incidence of complications which could be observed during induction and the relationship between these complications and the age, sex and weight of Koreans.
METHODS
Induction was done by etomidate 0.3 mg/kg and vecuronium 0.1 mg/kg. Pain on injection and hiccup were checked as present or absent. Myoclonus was checked as absent, mild, or severe.
RESULTS
The incidence of pain on injection, hiccup and myoclonus were 4%, 10%, and 40% (mild 28%, severe 12%) respectively. There was no association between pain on injection and hiccup or myoclonus. Hiccup and myoclonus had some association (Gamma 0.774). Logistic regression revealed that there was no association between pain on injection or hiccup, and sex, age or weight. Myoclonus had some association with age and weight. The occurrence of myoclonus could be estimated by the following equation. log[ Fj(x) / { 1 Fj(x) } ] = aj 0.061 age 0.019 weight j = 1, 2 As age or weight increased, the myoclonus was more likely to fall at the low end (i.e., absence).
CONCLUSIONS
The incidences of the pain on injection, hiccup and myoclonus were 4%, 10% and 40% respectively. The hiccup and the myoclonus had some positive association. The occurrence of myoclonus decreased as age or weight increased.