title: Rocuronium-induced withdrawal movements associated with different Rocuronium injection method.
abstract: OBJECTIVE
  One hundred and twenty patients (3-15 years old) were randomly enrolled (four groups: each group = 30 patients) in the study.
  
  
  OBJECTIVE
  The aim of this study was to compare the incidence and intensity of rocuronium-induced withdrawal movements in children injected with a typical intravenous bolus injection of rocuronium or with an infusion injection of rocuronium.
  
  
  BACKGROUND
  Intravenous bolus injection of rocuronium produces pain and withdrawal movement.
  
  
  METHODS
  Immediately after loss of consciousness by thiopental sodium (5 mg x kg(-1)), 0.6 mg x kg(-1) (B0.6, I0.6) or 0.9 mg x kg(-1) rocuronium (B0.9, I0.9) was injected by different method, either a bolus injection over 5 s (B0.6, B0.9) or an infusion injection lasting for 1 min (I0.6, I0.9). The withdrawal movement of the patients to the injection of rocuronium was assessed (four-grade score: 0-3). Intubating condition was assessed. Rocuronium-induced muscle relaxation time was measured by single twitch stimulation fade out.
  
  
  RESULTS
  The incidence (group B: 100%, group I: 33.3%) and the intensity of the withdrawal movements were significantly lower in the infusion groups compared with the bolus groups (P < 0.05). The intubating conditions for all groups were clinically acceptable (good to excellent). There was no significant difference in the muscle relaxation time between the different injection groups (I0.6; 105.6 +/- 7.7 vs B0.6; 114.6 +/- 8.0, I0.9; 69.2 +/- 3.6 vs B0.9; 73.4 +/- 1/0).
  
  
  CONCLUSIONS
  The infusion injection of rocuronium for tracheal intubation significantly reduced the incidence and intensity of withdrawal movement on injection of rocuronium, and it neither delays the onset of muscle relaxation nor deteriorates the intubating condition.
authors.affiliation: Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea.
authors.forename: Seung-Hoon
authors.initials: SH
authors.lastname: Baek
authors.forename: Chul-Min
authors.initials: CM
authors.lastname: Woo
authors.forename: Hyeon-Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Yoon
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Kwon
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Shin
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D000732:Androstanols / Q000008:administration & dosage* / Q000009:adverse effects; D000771:Anesthesia, Intravenous / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous / Q000379:methods; D007442:Intubation, Intratracheal; D008297:Male; D009068:Movement / Q000187:drug effects* / Q000502:physiology; D009126:Muscle Relaxation / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage* / Q000009:adverse effects; D010146:Pain / Q000139:chemically induced*; D010147:Pain Measurement; D000077123:Rocuronium; D016896:Treatment Outcome
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium