Myoclonus is defined as sudden, brief, involuntary muscle jerks either irregular or rhythmic, usually lasting 10-50 ms. In non premedicated patients, the incidence of myoclonus is as high as 50-80%. Myoclonus may lead to regurgitation and aspiration in patients with inadequate fasting, raised intraocular pressure in open-globe injuries with a risk of vitreal prolapse and increased myocardial oxygen consumption. Preventing the occurence of myoclonus is important as Etomidate is the preferred induction agent in hemodynamically unstable patients.

A large number of drugs have been studied for their ability to prevent these myoclonic movements. However, these drugs may be associated with side effects like excessive sedation, respiratory suppression and delayed recovery. It is possible to eliminate the need for an additional drug, its inherent cost or potential side effects by changong the techniques of Etomidate injection. Pre-treatment with a low dose of Etomidate (priming dose) and slow injection of the induction dose have both been shown to reduce the incidence of Etomidate induced myoclonus (EIM).

To the best of our knowledge, there are no studies comparing the efficacy of priming dose technique, induction dose given by slow injection technique and a combination of priming dose with slow injection technique in preventing EIM, Therefore, we are conducting this study to determine the efficacy of these techniques in reducing EIM, as the primary outcome. We also aim to study the efficacy of the three techniques on prevention of pain with administration of Etomidate and the effect on hemodynamic parameters of heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and peripheral oxygen saturation.