Comparing the Effect of Sodium Thiopental, Magnesium Sulfate, Midazolam, Prime Etomidate, and Remifentanil on Myoclonus Incidence and Pain Induced by Anesthesia with Etomidate

This study aimed to compare premedication with sodium thiopental, magnesium sulfate, midazolam, prime etomidate dosage, remifentanil, and normal saline on decreasing myoclonus incidence and pain induced by anesthesia with etomidate.
In a clinical trial study, 162 patients who were candidates for anesthesia were randomly entered in 6 equal groups. Two minutes before induction of anesthesia, patients were treated with intravenous thiopental, magnesium sulfate, midazolam, remifentanil, prime etomidate dosage, or normal saline. Pain, myoclonus, and complications were determined and compared between the groups.
Findings: Intensity of myoclonus was not significantly different between the six groups at zero, 10, and 15 minutes after anesthesia. But at 5th minute, midazolam (0.51) and fentanyl (0.81) groups had the lowest and magnesium sulfate (1.88) and prime etomidate dosage (1.77) groups had the highest myoclonus; the difference between the groups was significant (P = 0.002).
It seems that administration of midazolam with etomidate is the best choice for anesthesia. Therefore, it is recommended that this drug be used in combination with etomidate to induce anesthesia in patients. More studies are recommended.