Preventing the withdrawal response associated with rocuronium injection: a comparison of fentanyl with lidocaine.
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.
Ahmad
Norezalee
N
Hospital Sultanah Aminah, Johor Bahru, Malaysia; Department of Anesthesiology & Intensive Care, Hospital Universiti Kebangsaan Malaysia, Malaysia.
Choy
Choy Yin
CY
Aris
Esa Ab
EA
Balan
Subrahmanyam
S
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*
D000732:Androstanols; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D003473:Neuromuscular Nondepolarizing Agents; D008012:Lidocaine; D005283:Fentanyl; D000077123:Rocuronium