I.V. Infusion of Dezocine before Etomidate Administration for Myoclonus of Prevention Caused by Etomidate: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 LONGXia , WUBin ,  XUTing

Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding?author：

XUTing, Email: tingx2009@163.com

Keywords：

Dezocine; Etomidate; Myoclonus; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20150115

Video：

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Objective To systematically assess the effectiveness and safety of I.V. infusion of dezocine for prevention of myoclonus caused by etomidate. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 6, 2014), CNKI, WanFang Data and VIP were electronically searched from inception to May 2014 for randomized controlled trials (RCTs) on I.V. infusion of dezocine for prevention of myoclonus caused by etomidate. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2.3 software. Results Ten RCTs were included. The results of meta-analysis indicated that, dezocine could reduce the incidence of myoclonus induced by etomidate (RR=0.24，95%CI 0.12 to 0.45, P<0.000 1), and was better than fentanyl (RR=0.30, 95%CI 0.17 to 0.51, P<0.000 1); dezocine could reduce the amount of etomidate (MD=-4.70, 95%CI -6.62 to -2.79, P<0.000 01); compared with fentanyl, dezocine could reduce the incidence of injection pain (OR=0.25, 95%CI 0.10 to 0.62, P=0.003); dezocine did not increase the incidence of respiratory depression (OR=2.61, 95%CI 0.12 to 56.03, P=0.54). Conclusion I.V. infusion of dezocine before etomidate administration could reduce myoclonus incidence caused by etomidate, reduce the amount of etomidate, and is better than fentanyl; which could also reduce the incidence of injection pain, and not increase the incidence of respiratory depression.

Citation： LONGXia, WUBin, XUTing. I.V. Infusion of Dezocine before Etomidate Administration for Myoclonus of Prevention Caused by Etomidate: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(6): 693-698. doi: 10.7507/1672-2531.20150115 Copy

1.	胡紅專,秦榜勇.依托咪酯的藥理特點及臨床應用.醫學綜述,2013,19(8):1467-1469.
2.	Patel S.Cardiovascular effects of intravenous anesthetics.Int Anesthesiol Clin,2002,40(1):15-33.
3.	段淑芬,侯鐵柱,徐炳欣,等.地佐辛聯合依托咪酯在老年患者無痛胃鏡術中應用.中華實用診斷與治療雜志,2014,28(6):619-620.
4.	Doenicke A,Roizen M,Kugler J,et al.Reducing myoclonus after etomidate.Anesthesiology,1999,90(1):113-119.
5.	Kulka P,Bremer F,Schuttler J,et al.Anesthesia induction using etomidate in a lipid emulsion.Anaesthetist,1993,42(4):205-209.
6.	Mizrak A,Koruk S,Bilgi M,et al.Pretreatment with dexmedetomidine or thiopental decreases myoclonus after etomidate:a randomized,double-blind controlled trial.J Surg Res,2010,159(1):e11-e16.
7.	Ri H,Shin S,Kim T,et al.The proper effect site concentration of remifentanil for prevention of myoclonus after etomidate injection.Korean J Anesthesiol,2011,61(2):127-132.
8.	Gultop F,Akkaya T,Bedirli N,et al.Lidocaine pretreatment reduces the frequency and severity of myoclonus induced by etomidate.J Anesth,2010,24(2):300-302.
9.	He L,Ding Y,Chen H,et al.Dezocine pretreatment prevents myoclonus induced by etomidate:a randomized,double-blinded controlled trial.J Anesth,2015,29(1):143-145.
10.	Hueter L,Schwarzkopf K,Simon M,et al.Pretreatment with sufentanil reduces myoclonus after etomidate.Acta Anaesthesiol Scand,2003,47(4):482-484.
11.	宿穎嵐.地佐辛應用于剖宮產術后硬膜外自控鎮痛的效果觀察.海南醫學,2012,23(18):30-32.
12.	Cohen R,Edwards W,Kezer E,et al.Serial intravenous Doses of Dezocine,Morphine,and Naibuphine in the management of postoperative pain for outpatients.Anesth Analg,1993,77(3):533-539.
13.	李富州,秦志均.地佐辛的臨床應用進展.醫學綜述,2013,19(11):2065-2067.
14.	Higgins JPT,Green S (editors).Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011].The Cochrane Collaboration,2011,Available at:www.cochranehandbook.org.
15.	Lu Z,Fang J,Zhu J,et al.Intravenous dezocine pretreatment reduces the incidence and intensity of myoclonus induced by etomidate.J Anesth,2014,28(6):944-947.
16.	杜蘇華,王志偉,陳琳.地佐辛復合依托咪酯用于宮腔鏡檢查中的麻醉效果及安全性.齊齊哈爾醫學院學報,2013,34(17):2537-2538.
17.	傅柳.地佐辛或舒芬太尼復合依托咪酯用于無痛腸鏡檢查的臨床觀察.中國藥業,2013,22(Z2):31-32.
18.	李雄偉,昝京偉,張捷,等.地佐辛超前鎮痛在依托咪酯全麻誘導中的臨床觀察.中國醫藥指南,2013,11(22):48-50.
19.	廖少忠,盧貴明.地佐辛復合依托咪酯用于全麻上腹部手術伴高血壓患者的臨床分析.中國醫藥科學,2014,4(7):112-114.
20.	盧貴明,趙崇漢,陳珍愛,等.地佐辛聯合依托咪酯用于老年人無痛胃腸鏡檢查的臨床觀察.中國基層醫藥,2011,18(13):1797-1798.
21.	孟璐,李凱,趙國慶,等.地佐辛復合依托咪酯對于高血壓患者全麻誘導插管的效果觀察.中國實驗診斷學,2013,17(9):1726-1728.
22.	王勁,李曦.不同劑量地佐辛復合依托咪酯在無痛胃鏡檢查中的麻醉效果.海南醫學,2013,24(11):1605-1607.
23.	吳文華,周脈濤.地佐辛預處理對依托咪酯脂肪乳劑誘導肌陣攣和蘇醒質量的影響.職業與健康,2012,28(23):3007-3008.
24.	王新華,楊俊.依托咪酯引起肌震顫與腦內多巴胺受體關系的實驗研究.中華麻醉學雜志,1991,11(3):147-148.
25.	Herrera-Peco I,Wix-Ramos R,Dominguez-Gadea L,et al.Changes in cerebral perfusion induced by etomidate in patients with temporal lobe epilepsy.Rev Neurol,2009,49(11):561-565.
26.	Voss L,Sleigh J,Barnard J,et al.The howling cortex:seizures and general anesthetic drugs.Anesth Analg,2008,107(5):1689-1703.
27.	Loacker S,Sayyah M,Wittmann W,et al.Endogenous dynorphin in epileptogenesis and epilepsy:anticonvulsant net effect via kappa opioid receptors.Brain,2007,130(4):1017-1028.
28.	鄒丹,吳逢波,劉勇.地佐辛與芬太尼比較用于術后靜脈自控鎮痛有效性和安全性的系統評價.中國循證醫學雜志,2014,14(1):65-71.

1. 胡紅專,秦榜勇.依托咪酯的藥理特點及臨床應用.醫學綜述,2013,19(8):1467-1469.
2. Patel S.Cardiovascular effects of intravenous anesthetics.Int Anesthesiol Clin,2002,40(1):15-33.
3. 段淑芬,侯鐵柱,徐炳欣,等.地佐辛聯合依托咪酯在老年患者無痛胃鏡術中應用.中華實用診斷與治療雜志,2014,28(6):619-620.
4. Doenicke A,Roizen M,Kugler J,et al.Reducing myoclonus after etomidate.Anesthesiology,1999,90(1):113-119.
5. Kulka P,Bremer F,Schuttler J,et al.Anesthesia induction using etomidate in a lipid emulsion.Anaesthetist,1993,42(4):205-209.
6. Mizrak A,Koruk S,Bilgi M,et al.Pretreatment with dexmedetomidine or thiopental decreases myoclonus after etomidate:a randomized,double-blind controlled trial.J Surg Res,2010,159(1):e11-e16.
7. Ri H,Shin S,Kim T,et al.The proper effect site concentration of remifentanil for prevention of myoclonus after etomidate injection.Korean J Anesthesiol,2011,61(2):127-132.
8. Gultop F,Akkaya T,Bedirli N,et al.Lidocaine pretreatment reduces the frequency and severity of myoclonus induced by etomidate.J Anesth,2010,24(2):300-302.
9. He L,Ding Y,Chen H,et al.Dezocine pretreatment prevents myoclonus induced by etomidate:a randomized,double-blinded controlled trial.J Anesth,2015,29(1):143-145.
10. Hueter L,Schwarzkopf K,Simon M,et al.Pretreatment with sufentanil reduces myoclonus after etomidate.Acta Anaesthesiol Scand,2003,47(4):482-484.
11. 宿穎嵐.地佐辛應用于剖宮產術后硬膜外自控鎮痛的效果觀察.海南醫學,2012,23(18):30-32.
12. Cohen R,Edwards W,Kezer E,et al.Serial intravenous Doses of Dezocine,Morphine,and Naibuphine in the management of postoperative pain for outpatients.Anesth Analg,1993,77(3):533-539.
13. 李富州,秦志均.地佐辛的臨床應用進展.醫學綜述,2013,19(11):2065-2067.
14. Higgins JPT,Green S (editors).Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011].The Cochrane Collaboration,2011,Available at:www.cochranehandbook.org.
15. Lu Z,Fang J,Zhu J,et al.Intravenous dezocine pretreatment reduces the incidence and intensity of myoclonus induced by etomidate.J Anesth,2014,28(6):944-947.
16. 杜蘇華,王志偉,陳琳.地佐辛復合依托咪酯用于宮腔鏡檢查中的麻醉效果及安全性.齊齊哈爾醫學院學報,2013,34(17):2537-2538.
17. 傅柳.地佐辛或舒芬太尼復合依托咪酯用于無痛腸鏡檢查的臨床觀察.中國藥業,2013,22(Z2):31-32.
18. 李雄偉,昝京偉,張捷,等.地佐辛超前鎮痛在依托咪酯全麻誘導中的臨床觀察.中國醫藥指南,2013,11(22):48-50.
19. 廖少忠,盧貴明.地佐辛復合依托咪酯用于全麻上腹部手術伴高血壓患者的臨床分析.中國醫藥科學,2014,4(7):112-114.
20. 盧貴明,趙崇漢,陳珍愛,等.地佐辛聯合依托咪酯用于老年人無痛胃腸鏡檢查的臨床觀察.中國基層醫藥,2011,18(13):1797-1798.
21. 孟璐,李凱,趙國慶,等.地佐辛復合依托咪酯對于高血壓患者全麻誘導插管的效果觀察.中國實驗診斷學,2013,17(9):1726-1728.
22. 王勁,李曦.不同劑量地佐辛復合依托咪酯在無痛胃鏡檢查中的麻醉效果.海南醫學,2013,24(11):1605-1607.
23. 吳文華,周脈濤.地佐辛預處理對依托咪酯脂肪乳劑誘導肌陣攣和蘇醒質量的影響.職業與健康,2012,28(23):3007-3008.
24. 王新華,楊俊.依托咪酯引起肌震顫與腦內多巴胺受體關系的實驗研究.中華麻醉學雜志,1991,11(3):147-148.
25. Herrera-Peco I,Wix-Ramos R,Dominguez-Gadea L,et al.Changes in cerebral perfusion induced by etomidate in patients with temporal lobe epilepsy.Rev Neurol,2009,49(11):561-565.
26. Voss L,Sleigh J,Barnard J,et al.The howling cortex:seizures and general anesthetic drugs.Anesth Analg,2008,107(5):1689-1703.
27. Loacker S,Sayyah M,Wittmann W,et al.Endogenous dynorphin in epileptogenesis and epilepsy:anticonvulsant net effect via kappa opioid receptors.Brain,2007,130(4):1017-1028.
28. 鄒丹,吳逢波,劉勇.地佐辛與芬太尼比較用于術后靜脈自控鎮痛有效性和安全性的系統評價.中國循證醫學雜志,2014,14(1):65-71.

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Chinese Journal of Evidence-Based Medicine

I.V. Infusion of Dezocine before Etomidate Administration for Myoclonus of Prevention Caused by Etomidate: A Systematic Review

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