title: Single pretreatment of remifentanil may reduce pain after propofol and rocuronium injection in rapid sequence induction.
abstract: BACKGROUND
  We designed this double-blind, placebo-controlled study to compare the efficacy of remifentanil in reducing the pain of both propofol and rocuronium injection during rapid-sequence induction.
  
  
  METHODS
  Ninety-five patients, scheduled for elective surgery under general anesthesia, were divided into 3 groups: saline (Group S, n = 31), remifentanil 1 µg/kg (Group R, n = 32), and lidocaine 1.5 mg/kg (Group L, n = 32) were administered after tourniquet application. The occlusion was released after 1 min and 5 ml of 1% propofol was injected over 10 s. Pain on propofol injection was evaluated by a 10-point verbal numeric rating scale (VNRS). The rest of the induction dose of propofol and 1 mg/kg of rocuronium, were injected. Pain on rocuronium injection was evaluated by a four-point score (FPS).
  
  
  RESULTS
  THE VNRS OF PROPOFOL INJECTION WAS AS FOLLOWS: R (0.78) = L (1.34) < S (4.26). The incidence of withdrawal response due to rocuronium was as follows: R (6.3%) < L (53.1%) < S (83.9%). The FPS of rocuronium injection was as follows: R (0.81) < L (1.78) < S (2.93).
  
  
  CONCLUSIONS
  Pretreatment with a bolus of remifentanil was effective in simultaneously reducing injection pain of propofol and rocuronium. In addition, remifentanil pretreatment was more effective in suppression of withdrawal response by rocuronium than lidocaine.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Yoon Ji
authors.initials: YJ
authors.lastname: Choi
authors.forename: Han Seok
authors.initials: HS
authors.lastname: Park
authors.forename: Han
authors.initials: H
authors.lastname: Lee
authors.forename: Seung Zhoo
authors.initials: SZ
authors.lastname: Yoon