Alfentanil is comparable to remifentanil in preventing withdrawal movement following rocuronium injection.
OBJECTIVE
To evaluate and compare the efficacy and related side effects of alfentanil and remifentanil in preventing the withdrawal movement associated with rocuronium injection.


METHODS
Prospective, randomized, blinded, placebo-controlled clinical trial.


METHODS
Operating room of a university hospital.


METHODS
115 ASA physical status I and II adult patients.


METHODS
Patients were randomly allocated to one of three study groups. Group C received saline, Group A received alfentanil 10 microg/kg, and Group R received remifentanil one microg/kg, each in a volume of three mL. Treatments were injected over 30 seconds, followed by thiopental sodium. At 90 seconds after the start of the study drug injection, rocuronium 0.6 mg/kg was injected over 10 seconds.


METHODS
Cough, breathholding, and thoracic muscle rigidity were observed while injecting the study drug. Each patient's response to the rocuronium injection was graded on a 4-point scale in a blinded manner.


RESULTS
During injection of the study drug, Group R showed a significantly higher frequency of cough than Group A (24% vs. 2%; P < 0.05). One Group R patient presented with apnea. Frequency of withdrawal movement in Groups A and R were significantly lower than that in Group C (6% and 0% vs. 63%; P < 0.0001) but there was no significant difference between the two groups.


CONCLUSIONS
When administered 90 seconds before rocuronium injection, alfentanil showed a comparable effect to that of remifentanil in attenuating rocuronium-associated withdrawal movement, and a lower frequency of side effects such as cough.
Kim
Jin-Hee
JH
Department of Anesthesiology, Seoul National University Medical College, Seoul 110-744, South Korea.
Kim
Jang-Hyun
JH
Han
Sung-Hee
SH
Hwang
Jung-Won
JW
Oh
Ah-Young
AY
D000328:Adult; D015760:Alfentanil / Q000009:adverse effects / Q000627:therapeutic use*; D000732:Androstanols / Q000009:adverse effects* / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D003371:Cough / Q000139:chemically induced; D004311:Double-Blind Method; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects / Q000627:therapeutic use; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D000077208:Remifentanil; D000077123:Rocuronium; D013874:Thiopental / Q000627:therapeutic use
D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D015760:Alfentanil; D013874:Thiopental; D000077208:Remifentanil; D000077123:Rocuronium