Superficial venous thrombophlebitis caused by rocuronium.
Pain is one of the major disadvantages of rocuronium, which is used during induction of anesthesia. Even at subparalyzing doses, 50-100% of patients complain of intense pain. Sudden flexion and withdrawal movement in the wrist or arm have been reported following rocuronium use in many papers. No information about risk factors leading to this withdrawal movement or pain on injection is available and whether this reaction leads to erythema or to venous sequelae (i.e. thrombosis and thrombophlebitis) has not been systematically investigated. However, in both of our cases, visible reactions occurred and both patients were diagnosed with venous superficial thrombophlebitis. Therefore, we believe that rocuronium-related pain may, in part, be because of direct venous injury.
Eyigor
Can
C
Anesthesiology Department, Faculty of Medicine, Pain Clinic, Ege University, 35100, Bornova, Izmir, Turkey. can.eyigor@yahoo.com.tr
Ceylan
Arda
A
Demir
Fusun
F
Ayanoglu
H Omer
HO
Ugur
Gulden
G
D000732:Androstanols / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects*; D000077123:Rocuronium; D013924:Thrombophlebitis / Q000139:chemically induced*; D055815:Young Adult
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium
Br J Anaesth. 1991 Feb;66(2):189-95
1817619
Anesth Analg. 1996 Jul;83(1):203
8659757
Br J Anaesth. 2000 Jan;84(1):106-7
10740559
Br J Anaesth. 1999 Sep;83(3):397-404
10655909
Br J Anaesth. 1992 Sep;69(3):269-73
1389845
Eur J Anaesthesiol. 2003 Mar;20(3):245-53
12650497
J Clin Anesth. 2007 Sep;19(6):418-23
17967669
Br J Anaesth. 1996 Apr;76(4):481-3
8652315
Br J Anaesth. 1997 Sep;79(3):382-3
9389860
Anesth Analg. 1995 May;80(5):1067
7726421
J Clin Anesth. 2006 Aug;18(5):334-8
16905077
J Clin Anesth. 1997 Dec;9(8):650-2
9438893