Comparison of dexmedetomidine and midazolam in prevention of myoclonus occurring due to etomidate in coronary bypass surgery

Objectives: Etomidate is frequently employed in patients with unstable hemodynamics due its low cardiopul- monary side effects. Besides the common side effects, myoclonus induced by etomidate is a serious problem. Several agents were proposed for inhibition of myoclonus, but they were not compared. In this study we aimed to compare the efficacy of dexmedetomidine and midazolam in etomidate induced myoclonus. Materials and Methods: Sixty patients undergoing elective coronary bypass surgery were prospectively randomized into two groups. Patients in group D were administered dexmedetomidine and in group M re- ceived midazolam prior to etomidate use. Sedation, pain in the injection site and myoclonus were evaluated by scoring systems. Results: The preoperative demographic characteristics of the patients were comparable in two groups. Seda- tion scores were lower in dexmedetomidine group (p<0.05). Patients in deexmedetomidine group did not ex- perience pain in the injection site at all, but patients receiving midazolam did (p<0.05). Severe myoclonus was not observed in both groups, only mild myoclonus were more common in dexmedetomidine group (p<0.05). Conclusions: Both agents decreased etomidate induced myoclonus. We believe that due to absence of signifi - cant cardiovascular side effects, both agents can be employed as pretreatment agents with etomidate especial- ly in patients with low cardiac reserve.