The comparison of Midazolam and Dexmedetomidin?s effects on induction when applied before etomidate

In our study, it is aimed to compare the effects of etomidate consumption and the duration of the loss of eyelash reflex and the incidence of injection pain and myoclonus besides the possible response of hemodynamic effect during the induction with saline, midazalom and dexmedetomidine before applying etomidate. Our study has been conducted on the group of selectively to-be-operated152 patients aged between 15 and 70, ASA I-III. The incidences were routinely monitored. Furthermore, the depth of anestesia was followed by BIS. The patients were randomly grouped in to three and group I was given saline before etomidate, group II midazalom (100µg/kg), and group III dexmedetodimine (1µg/kg within 10 min.s i.v). Consequently, the induction was done with etomidate until the loss of eyelash reflex. The duration of the loss of eyelash reflex and the amount of etomidate given were recorded. It was used the combination of sevoflurane (2%) and N20/02. The systolic (SAP), diyastolic arterial pressure (DAP), the pulse and oxygen saturation, BIS values and pre-operative sedation levels of the patients were measured and recorded after the first and the third minutes of the medication and following the first and the third minutes of induction of etomidate. The demographic data for the groups of patients were similar in our study (p>0.05). BIS values of midazolam group were lower than dexmedetomidine group, and sedation scores were higher (p<0.05). Subsequent to the application of etomidate, in the first and the third minutes, BIS values were between 39 and 41 in the groups. (p>0.05). The duration of the loss of eyelash reflex was shorter compared to the values of the groups of saline and dexmedetomidine (p=0.000 and p=0.029, respectively). The doze of etomidate induction was lower in midazolam and dexmedetomidine groups compared to saline?s (p=0.000). The incidence of myoclonus and injection pain occurred higher in etomidate group than the others (p=0,000). On the first and the third minutes after etomidate, SAP and DAP were seen lower in dexmedetomidine group compared to midazolam and saline. (p<0.05). Pulse values were always measured lower in all times except from pre-operations. (p<0.05). Resting heart rate values except from preopreatıve values were lower at all times in dexmedetomidin group compared to the others (p<0.05). The application of midazolam and dexmedetomidine, before etomidate, has been proved that it decreases the myoclonus and injection pain incidence which are inducted by etomidate, lowered the doses of etomidate for induction and the duration of loss of eyelash reflex and provided a better hemodynamic stability of the application of dexmedetomidine.Keywords: Etomidate, dexmedetomidine, midazolam, myoclonus, injection pain.