Effect of dexmedetomidine in preventing etomidate-induced myoclonus: a meta-analysis

Xueke Du, Chengmao Zhou, Linghui Pan, Changlong Li, Xueke Du, Chengmao Zhou, Linghui Pan, Changlong Li

Abstract

Objective: To investigate the effect of dexmedetomidine in the prevention of etomidate-induced myoclonus.

Methods: We searched for randomized controlled trials (RCTs) regarding the use of dexmedetomidine in preventing etomidate-induced myoclonus in the databases PubMed, EMBASE, the Cochrane Library, and CNKI. We extracted data and assessed the quality of the literature and adopted RevMan 5.2 to conduct meta-analysis on each effective index and employed funnel plot to test publication bias.

Results: The results showed that the incidence of etomidate-induced myoclonus in the dexmedetomidine treated groups was significantly lower than that of the control groups (risk ratio [RR]=0.27, 95% confidence interval [CI] [0.15, 0.47], P<0.00001). With regard to the severity of etomidate-induced myoclonus, incidences of etomidate-induced myoclonus in the dexmedetomidine treated groups resulting in mild myoclonus (RR=0.37, 95% CI [0.19, 0.75], P=0.006), moderate myoclonus (RR=0.21, 95% CI [0.12, 0.37], P<0.00001), or severe myoclonus (RR=0.18, 95% CI [0.08, 0.38], P<0.00001) were significantly lower than those of the control groups. No statistically significant difference was found (RR=0.70, 95% CI [0.47, 1.04], P=0.08) between etomidate-induced myoclonus in the dexmedetomidine treated groups and that of the midazolam treated groups.

Conclusion: Dexmedetomidine can effectively prevent the incidence of etomidate-induced myoclonus and reduce the severity of etomidate-induced myoclonus. In addition, there were no significant differences between the effects of dexmedetomidine and midazolam in preventing etomidate-induced myoclonus.

Keywords: dexmedetomidine; etomidate; meta-analysis; myoclonus-chemically induced.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram. Abbreviation: RCTs, randomized controlled trials.
Figure 2
Figure 2
Effect of dexmedetomidine in preventing etomidate-induced myoclonus. Abbreviations: CI, confidence interval; df, degrees of freedom; M–H, Mantel–Haenszel.
Figure 3
Figure 3
The incidence of etomidate-induced myoclonus in the dexmedetomidine and midazolam treated groups. Abbreviations: CI, confidence interval; df, degrees of freedom; M–H, Mantel–Haenszel.
Figure 4
Figure 4
Mild myoclonus. Abbreviations: CI, confidence interval; df, degrees of freedom; M–H, Mantel–Haenszel.
Figure 5
Figure 5
Moderate myoclonus. Abbreviations: CI, confidence interval; df, degrees of freedom; M–H, Mantel–Haenszel.
Figure 6
Figure 6
Severe myoclonus. Abbreviations: CI, confidence interval; df, degrees of freedom; M–H, Mantel–Haenszel.

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Source: PubMed

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