A comparison of the efficacies of different pre-treatment drugs in resolving the injection pain of rocuronium.
Efficacies of pre-treatment with lidocaine, remifentanil and metoclopramide in the reduction of pain and withdrawal movements induced by rocuronium injection were evaluated. Forty-four adult patients, American Society of Anesthesiologists (ASA) Physical Status I-II, undergoing elective surgery were randomly assigned to four groups. Each patient received intravenously either 10 mg metoclopramide, 50 mg lidocaine, 1 microg/kg remifentanil or 3 ml of 0.9% sodium chloride (control group); followed by occlusion with a tourniquet on the forearm. After 10 s, occlusion stopped and a priming dose of 0.06 mg/kg rocuronium was injected. The patient's response to rocuronium was graded using a four-point scale in a double-blind manner. All groups had significantly lower incidences of pain compared with the control group. After loss of consciousness with sodium thiopental, 0.6 mg/kg rocuronium was administered for intubation and withdrawal movements were assessed. The number of patients in whom withdrawal movements were lowest was in the lidocaine-treated group. Although there was no difference among the study drugs in the prevention of rocuronium-induced pain, lidocaine and remifentanil seemed to be clinically more effective than metoclopramide.
Ertugrul
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Department of Anaesthesiology and Reanimation, Faculty of Medicine, Akdeniz University, Antalya, Turkey. fertug@hotmail.com
D000328:Adult; D000732:Androstanols / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage*; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage* / Q000009:adverse effects; D010146:Pain / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage*; D011292:Premedication; D000077208:Remifentanil; D000077123:Rocuronium
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D008012:Lidocaine; D008787:Metoclopramide; D000077208:Remifentanil; D000077123:Rocuronium