title: Comparison of randomized preemptive dexketoprofen trometamol or placebo tablets to prevent withdrawal movement caused by rocuronium injection.
abstract: Rocuronium is a non-depolarizing neuromuscular blocking agent which is associated with injection pain and induces withdrawal movement of the injected hand or arm or generalized movements of the body after intravenous injection. The aim of this randomized study was to compare the efficacy of pretreatment with oral dexketoprofen trometamol (Arvelles(®); Group A) with placebo (Group P) without tourniquet to prevent the withdrawal response caused by rocuronium injection. The study cohort comprised 150 American Society of Anaesthesiologists class I-III patients aged 18-75 years who were scheduled to undergo elective surgery with general anesthesia. The patients response to rocuronium was graded using a 4-point scale [0 = no response; 1 = movement/withdrawal at the wrist only, 2 = movement/withdrawal involving the arm only (elbow/shoulder); 3 = generalized response]. The overall incidence of withdrawal movement after rocuronium injection was significantly lower in Group A (30.1 %) than in Group P (64.6 %) (p < 0.001). The incidence of score 0 withdrawal movements was higher in Group A (69.9 %) than in Group P (35.4 %), that of score 1 withdrawal movements was similar between groups (Group A 21.9 %; Group B 26.1 %) (p = 0.560) and that of score 2 withdrawal movements was lower in Group A (8.2 %) than in Group P (38.5 %) (p < 0.001). There were no score 3 withdrawal movements in either group (p > 0.05). These results demonstrate that the preemptive administration of dexketoprofen trometamol can attenuate the degree of withdrawal movements caused by the pain of the rocuronium injection.
authors.affiliation: Department of Anesthesiology, Ministry of Health Diskapi Yildirim Beyazit Research and Training Hospital, Ankara, Turkey.
authors.forename: Gözde Bumin
authors.initials: GB
authors.lastname: Aydın
authors.forename: Reyhan
authors.initials: R
authors.lastname: Polat
authors.forename: Julide
authors.initials: J
authors.lastname: Ergil
authors.forename: Murat
authors.initials: M
authors.lastname: Sayın
authors.forename: Ceyda Ozhan
authors.initials: CO
authors.lastname: Caparlar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000732:Androstanols / Q000008:administration & dosage / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D007660:Ketoprofen / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D000077123:Rocuronium; D014325:Tromethamine / Q000627:therapeutic use*
chemical_list: D000732:Androstanols; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003473:Neuromuscular Nondepolarizing Agents; D014325:Tromethamine; D007660:Ketoprofen; C118296:dexketoprofen trometamol; D000077123:Rocuronium