title: Preventing the withdrawal response associated with rocuronium injection: a comparison of fentanyl with lidocaine.
abstract: We compared the efficacy of IV fentanyl with IV lidocaine as pretreatment for the prevention of withdrawal response after rocuronium injection. For this prospective, randomized, placebo-controlled, double-blind study we recruited 90 patients aged between 18 and 65 yr, ASA physical status I or II, who had undergone elective surgery requiring general anesthesia and positive pressure ventilation. Patients were randomly allocated to 1 of 3 groups: group F received 2 mL IV fentanyl 50 microg/mL (100 microg), group L received 2 mL of preservative-free lidocaine 2% (40 mg), and group P (placebo) received 2 mL of normal saline. The incidence of withdrawal response after rocuronium was 57%, 30%, and 7% in the placebo, lidocaine, and fentanyl groups, respectively. We found a significant reduction in incidence of withdrawal response in both the fentanyl and lidocaine groups when compared with the placebo group (P < 0.05), with the fentanyl group being most effective (P < 0.05). In conclusion, both fentanyl and lidocaine are effective clinical treatments to alleviate the withdrawal response associated with rocuronium injection, with fentanyl being more effective.
authors.affiliation: Hospital Sultanah Aminah, Johor Bahru, Malaysia; Department of Anesthesiology & Intensive Care, Hospital Universiti Kebangsaan Malaysia, Malaysia.
authors.forename: Norezalee
authors.initials: N
authors.lastname: Ahmad
authors.forename: Choy Yin
authors.initials: CY
authors.lastname: Choy
authors.forename: Esa Ab
authors.initials: EA
authors.lastname: Aris
authors.forename: Subrahmanyam
authors.initials: S
authors.lastname: Balan
mesh_terms: D000293:Adolescent; D000328:Adult; D000732:Androstanols / Q000008:administration & dosage / Q000009:adverse effects*; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D000077123:Rocuronium; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control*
chemical_list: D000732:Androstanols; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D003473:Neuromuscular Nondepolarizing Agents; D008012:Lidocaine; D005283:Fentanyl; D000077123:Rocuronium