title: Can ephedrine pretreatment be effective in alleviating rocuronium injection pain?
abstract: OBJECTIVE
  The aim of this randomized, double-blind, placebo-controlled study was to evaluate the effect of ephedrine pretreatment on the intensity of rocuronium injection pain when rocuronium was applied by timing principle and also to compare this effect with lidocaine and placebo.
  
  
  METHODS
  120 American Society of Anesthesiology risk score I-II patients scheduled for elective surgery under general anesthesia were randomized into three groups to receive either 70 μg/kg ephedrine (ephedrine group, n = 40) or 0.5 mg/kg lidocaine (lidocaine group, n = 40) or 5 ml NaCl 0.9% (placebo group, n = 40) as pretreatment. Thirty seconds after pretreatment drugs, rocuronium 0.6 mg/kg was administered by the timing principle and rocuronium injection pain scores were recorded. Twenty seconds after rocuronium administration, anesthesia was induced with thiopental and the patient's trachea was intubated. Hemodynamic parameters and adverse effects were recorded.
  
  
  RESULTS
  The overall frequency of having pain was 82.5, 52.5 and 22.5% in placebo, ephedrine and lidocaine groups, respectively. Although the frequency of mild and moderate pain scores was higher in the ephedrine group than in the lidocaine group, this difference was not statistically significant (p = 0.032 and p = 0.001, respectively).
  
  
  CONCLUSIONS
  Although not as effective as lidocaine 0.5 mg/kg, 70 μg/kg ephedrine pretreatment was able to alleviate rocuronium injection pain when rocuronium was applied by timing principle.
authors.affiliation: Department of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Ankara, Turkey. zeynepakcaboy@yahoo.com
authors.forename: Zeynep Nur
authors.initials: ZN
authors.lastname: Akcaboy
authors.forename: Erkan Yavuz
authors.initials: EY
authors.lastname: Akcaboy
authors.forename: Ozlem Balkız
authors.initials: OB
authors.lastname: Soyal
authors.forename: Guldane
authors.initials: G
authors.lastname: Turhan
authors.forename: Nermin
authors.initials: N
authors.lastname: Gogus
mesh_terms: D000328:Adult; D000732:Androstanols / Q000008:administration & dosage* / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004809:Ephedrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D010146:Pain / Q000139:chemically induced* / Q000517:prevention & control*; D000077123:Rocuronium
chemical_list: D000732:Androstanols; D000779:Anesthetics, Local; D003473:Neuromuscular Nondepolarizing Agents; D008012:Lidocaine; D004809:Ephedrine; D000077123:Rocuronium