A Comparative Study between low dose Ketamine and low dose Propofol for the reduction of myoclonus caused by Etomidate as an induction agent.

Etomidate is a short-acting intravenous anesthetic agent used primarily for the induction of general

anesthesia and sedation for short procedure. Etomidate works by enhancing the activity of

gamma-aminobutyric acid (GABA) at the GABA A receptors, which are inhibitory neurotransmitters

in the brain. This results in central nervous system depression and sedation. Although Etomidate is

widely preferred due to its minimal cardiovascular and respiratory stability, one of its notable side

effects is myoclonus,especially during the induction phase of anaesthesia . Etomidate

induced myoclonus refers to involuntary,brief,jerky muscle movements that can occur after the

administration of Etomidate.

The exact cause of Etomidate induced myoclonus is not fully understood but it is thought to be related to the

disinhibition of subcortical structures that are normally suppressed by the brain, resulting in

transient,uncoordinated muscle activity.Myoclonus can lead to damage of muscle fibers, myalgia,

patient discomfort and can also be detrimental in patients with low cardiac reserve.

Etomidate induced myoclonus can be managed by premedicating with other agents like Dexmedetomidine,

Midazolam,Low dose Ketamine,Gabapentin,Dezocine,Magnesium sulfate,Opioids .Low dosePropofol and

low dose Ketamine are two such agents that have been studied for their efficacy in reducing Etomidate-induced myoclonus.

Here is a comparison of the two:Propofol is a sedative-hypnotic agent that works by enhancing GABA A receptor activity,

leading to increased inhibitory neurotransmission and Ketamine is an NMDA receptor antagonist that provides analgesia

and sedation by blocking excitatory neurotransmission . Therefore our aim for this study is to conpare the low dose

Ketamine and low dose Propofol for the reduction of myoclonus caused by Etomidate as an induction agent.