Rocuronium-induced withdrawal movements associated with different Rocuronium injection method.
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.
Baek
Seung-Hoon
SH
Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea.
Woo
Chul-Min
CM
Lee
Hyeon-Jeong
HJ
Yoon
Ji-Young
JY
Kwon
Jae-Young
JY
Shin
Sang-Wook
SW
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
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium