title: Dexmedetomidine reduces pain associated with rocuronium injection without causing a decrease in BIS values: a dose-response study.
abstract: OBJECTIVE
  To examine whether dexmedetomidine reduces the injection pain of propofol and rocuronium and to investigate whether the decrease in injection pain is associated with the known sedative action of dexmedetomidine.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled clinical comparison study.
  
  
  METHODS
  Patients undergoing general anesthesia with intubation received 40 mg of 1% lidocaine (lidocaine group; n = 28), 0.25 μg/kg of dexmedetomidine (low-dose group; n = 27), 0.5 μg/kg of dexmedetomidine (subclinical dose group; n = 28), 1.0 μg/kg of dexmedetomidine (clinical dose group, n = 27), or normal saline (saline group; n = 28) before anesthetic induction.
  
  
  METHODS
  Pain associated with propofol and rocuronium injection was assessed using a 10-point verbal analog scale (VAS) and a 4-point withdrawal movement scale, respectively. The BIS value was measured 60 seconds after administration of the study drug, and at the time of rocuronium injection and intubation.
  
  
  RESULTS
  The overall incidence of withdrawal movements due to rocuronium decreased significantly as the dose of dexmedetomidine increased (92.8%, 85.2%, 78.6%, and 51.9% in the saline, low-dose, subclinical dose, and clinical dose groups, respectively; P = 0.001). There was no significant difference in BIS values among the groups 60 seconds after study drug administration or at the time of rocuronium injection.
  
  
  CONCLUSIONS
  Dexmedetomidine reduced pain associated with rocuronium injection in a dose-dependent manner. This effect was not associated with the decrease in BIS value.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Joo
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.
authors.forename: Jungwon
authors.initials: J
authors.lastname: Baek
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea. Electronic address: jmlee@catholic.ac.kr.
authors.forename: Jaemin
authors.initials: J
authors.lastname: Lee
mesh_terms: D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000627:therapeutic use; D000732:Androstanols / Q000008:administration & dosage / Q000009:adverse effects*; D000768:Anesthesia, General / Q000379:methods; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D011292:Premedication / Q000379:methods; D015742:Propofol / Q000009:adverse effects; D000077123:Rocuronium; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D020927:Dexmedetomidine; D000077123:Rocuronium; D015742:Propofol
keywords: Bispectral index; Dexmedetomidine; Injection pain; Propofol; Rocuronium