title: Effect of pretreatment with acetaminophen on withdrawal movements associated with injection of rocuronium: a prospective, randomized, double-blind, placebo controlled study.
abstract: BACKGROUND
  Withdrawal movement during rocuronium injection is a common, unresolved adverse effect. We aimed to investigate the effect of IV acetaminophen pretreatment on withdrawal movement during rocuronium injection.
  
  
  METHODS
  This study enrolled 120 American Society of Anesthesiologists (ASA) I-II patients undergoing general anesthesia. They were randomly assigned to three treatment groups. After occluding venous drainage using a tourniquet on the upper arm, the saline group received 5 ml of 0.9% sodium chloride solution, the lidocaine group received 40 mg of lidocaine, and the acetaminophen group received 50 mg of acetaminophen. During injection of pretreatment drug, pain was assessed on a four-point scale. The tourniquet was released after 120 seconds and anesthesia was performed using thiopental sodium 5 mg/kg followed by rocuronium 0.6 mg/kg. The withdrawal movement was graded on a four-point scale in a double-blind manner.
  
  
  RESULTS
  The incidence of pain on pretreatment injection in saline, lidocaine, and acetaminophen groups was 7.7%, 5.1%, and 2.5%, respectively. The incidence of withdrawal movements was 77.5% in saline group, 32.5% in lidocaine group, and 37.5% in acetaminophen group (P < 0.05).
  
  
  CONCLUSIONS
  Acetaminophen and lidocaine reduced the incidence of withdrawal movement after rocuronium injection compared with saline.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Younghoon
authors.initials: Y
authors.lastname: Jeon
authors.forename: Sung-Uk
authors.initials: SU
authors.lastname: Baek
authors.forename: Sung Sik
authors.initials: SS
authors.lastname: Park
authors.forename: Si Oh
authors.initials: SO
authors.lastname: Kim
authors.forename: Woon-Yi
authors.initials: WY
authors.lastname: Baek
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Yeo