Zhou Chengmao, Zhu Yu, Liu Zhen, Ruan Lin
1 Department of Anaesthesiology, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China.
2 Department of Clinical Medicine, Zhaoqing Medical College, Zhaoqing, China.
J Int Med Res. 2017 Apr;45(2):399-406. doi: 10.1177/0300060516682882. Epub 2017 Feb 2.
Objective To investigate the effect of pretreatment with midazolam on myoclonus induced by etomidate injection. Methods A meta-analysis was performed using Review Manager software, version 5.2. Two researchers independently searched PubMed, Cochrane Library, and Embase® databases for randomized controlled trials involving patients who underwent etomidate induced general anaesthesia with or without midazolam pretreatment, published between 1990 and 2016. Outcome measures comprised overall myoclonus incidence rate and incidence rate classified by degree of myoclonus following etomidate injection. Data were assessed using a fixed effects model. Results Five studies, comprising 302 patients, were included for analysis. Overall incidence rate of etomidate injection-induced myoclonus was significantly lower in the pooled midazolam group versus controls (relative risk [RR] 0.34, 95% confidence interval [CI] 0.26, 0.44); Results subgrouped by degree of myoclonus showed significantly lower incidence in midazolam groups versus control groups for mild myoclonus (RR 0.56, 95% CI 0.39, 0.80); moderate myoclonus (RR 0.20, 95% CI 0.10, 0.41); and severe myoclonus (RR 0.12, 95% CI 0.04, 0.39). Conclusion Midazolam can effectively prevent etomidate-induced myoclonus, and alleviate the degree of etomidate-induced myoclonus.
目的 探讨咪达唑仑预处理对依托咪酯注射所致肌阵挛的影响。方法 使用5.2版Review Manager软件进行荟萃分析。两名研究人员独立检索PubMed、Cochrane图书馆和Embase®数据库，查找1990年至2016年间发表的涉及接受依托咪酯诱导全身麻醉且有或无咪达唑仑预处理患者的随机对照试验。观察指标包括依托咪酯注射后肌阵挛总发生率及按肌阵挛程度分类的发生率。数据采用固定效应模型进行评估。结果 纳入5项研究，共302例患者进行分析。在合并的咪达唑仑组中，依托咪酯注射所致肌阵挛的总发生率显著低于对照组（相对危险度[RR] 0.34，95%置信区间[CI] 0.26，0.44）；按肌阵挛程度分组的结果显示，咪达唑仑组轻度肌阵挛（RR 0.56，95% CI 0.39，0.80）、中度肌阵挛（RR 0.20，95% CI 0.10，0.41）和重度肌阵挛（RR 0.12，95% CI 0.04，0.39）发生率均显著低于对照组。结论 咪达唑仑可有效预防依托咪酯所致肌阵挛，并减轻依托咪酯所致肌阵挛的程度。
