title: Alfentanil is comparable to remifentanil in preventing withdrawal movement following rocuronium injection.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Seoul National University Medical College, Seoul 110-744, South Korea.
authors.forename: Jin-Hee
authors.initials: JH
authors.lastname: Kim
authors.forename: Jang-Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Han
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Hwang
authors.forename: Ah-Young
authors.initials: AY
authors.lastname: Oh
mesh_terms: 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
chemical_list: D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D015760:Alfentanil; D013874:Thiopental; D000077208:Remifentanil; D000077123:Rocuronium