title: The analgesic effect of remifentanil on prevention of withdrawal response associated with the injection of rocuronium in children: no evidence for a peripheral action.
abstract: Remifentanil pre-treatment has been reported to decrease the incidence of rocuronium injection-associated withdrawal movement. This study was designed to explore the site of action of remifentanil for reducing withdrawal response during rocuronium injection in children. Ninety-six paediatric patients were randomly assigned to three groups. After induction of anaesthesia with 5 mg/kg 2.5% thiopental sodium, 2 ml saline (placebo group) or 0.5 microg/kg remifentanil (group R), was injected intravenously 1 min before 0.6 mg/kg rocuronium. In a third group (group R'), the venous retention of 0.5 microg/kg remifentanil was maintained for 30 s followed by tourniquet release and injection of 0.6 mg/kg rocuronium. Withdrawal response was graded using a four-point scale. The incidence of withdrawal movement after rocuronium administration was 94%, 22% and 81% in the placebo, R, and R' groups, respectively. This study demonstrated that the pre-treatment effect of remifentanil for reducing rocuronium-associated withdrawal response occurs mainly through a central action.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, St. Mary's Hospital, The Catholic University of Korea, Bucheon, Republic of Korea.
authors.forename: J R
authors.initials: JR
authors.lastname: Yoon
authors.forename: Y
authors.initials: Y
authors.lastname: Jeon
authors.forename: Y
authors.initials: Y
authors.lastname: Yoo
authors.forename: H J
authors.initials: HJ
authors.lastname: Shin
authors.forename: J H
authors.initials: JH
authors.lastname: Ahn
authors.forename: C H
authors.initials: CH
authors.lastname: Lim
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000732:Androstanols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009068:Movement / Q000187:drug effects*; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use*; D010880:Piperidines / Q000009:adverse effects*; D011292:Premedication; D011446:Prospective Studies; D000077208:Remifentanil; D000077123:Rocuronium; D013375:Substance Withdrawal Syndrome / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000701:Analgesics, Opioid; D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D000077208:Remifentanil; D000077123:Rocuronium