title: Prevention of withdrawal associated with the injection of rocuronium in adults and children.
abstract: OBJECTIVE
  To determine which technique prevents the withdrawal associated with rocuronium administration in adults and children.
  
  
  METHODS
  Blinded, randomized, prospective trial.
  
  
  METHODS
  This study was set at an inpatient anesthesia in a university teaching hospital.
  
  
  METHODS
  200 adult patients (aged 19-63 years) and 150 children (aged 2-9 years) undergoing elective surgery requiring endotracheal intubation.
  
  
  METHODS
  Four groups in adult and 3 groups in children of 50 patients each were investigated. In adult study, control groups with free intravenous (IV) flow (C-F) or the occlusion of IV flow (C-O) received saline as the pretreatment of rocuronium; lidocaine groups with free IV flow (L-F) or the occlusion of IV flow (L-O) received lidocaine as the pretreatment of rocuronium, preceded by thiopental 5 seconds before. In children study, groups P and L received saline and lidocaine as the pretreatment of rocuronium, respectively, and group S received rocuronium mixed with sodium bicarbonate after the pretreatment of placebo preceded by thiopental.
  
  
  RESULTS
  The patient's response to rocuronium injection was graded using a 4-point scale. The pH and osmolality of treatment solution were measured. The incidence of no movement after rocuronium was 96% in L-O, 46% in L-F, 26% in C-O, and 18% in C-F in adult and 96% in S, 58% in L, and 8% in P in children.
  
  
  CONCLUSIONS
  Withdrawal after rocuronium can be eliminated by the pretreatment of lidocaine during the occlusion of the IV flow in adults and addition of sodium bicarbonate in children.
authors.affiliation: Department of Anesthesiology, Hanyang University Hospital, Seoul 133-792, Korea. kimks@hanyang.ac.kr
authors.forename: Kyo S
authors.initials: KS
authors.lastname: Kim
authors.forename: Young S
authors.initials: YS
authors.lastname: Kim
authors.forename: Woo J
authors.initials: WJ
authors.lastname: Jeon
authors.forename: Jong H
authors.initials: JH
authors.lastname: Yeom
mesh_terms: D000328:Adult; D000367:Age Factors; D000732:Androstanols / Q000008:administration & dosage / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods; D007442:Intubation, Intratracheal; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control; D011446:Prospective Studies; D000077123:Rocuronium; D012737:Sex Factors; D012965:Sodium Chloride / Q000008:administration & dosage; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control*; D013874:Thiopental / Q000008:administration & dosage
chemical_list: D000732:Androstanols; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D003473:Neuromuscular Nondepolarizing Agents; D012965:Sodium Chloride; D008012:Lidocaine; D013874:Thiopental; D000077123:Rocuronium