title: Effects of pretreatment with esmolol and lidocaine on injection pain and rocuronium-induced withdrawal response.
abstract: OBJECTIVE
  We aimed to compare the effectiveness of esmolol 1 mg/kg and lidocaine 1 mg/kg for injection pain and for the prevention of rocuronium-induced withdrawal response.
  
  
  METHODS
  We enrolled a total of 81 patients in the study. Patients were randomly assigned to receive either 10 mL of 0.9% NaCl (Group P), esmolol 1 mg/kg (Group E), or lidocaine 1.0 mg/kg (Group L). A subparalyzing dose of rocuronium 0.05 mg/ kg was administered to all patients and its effects were recorded. Anesthesia was induced with intravenous propofol and intravenous rocuronium 0.5 mg/kg in all groups. The withdrawal movements of the patient groups were subsequently graded.
  
  
  RESULTS
  There was a statistically significant difference in overall incidence of pain in group E and L compared to the placebo group after administrating the subparalyzed dose (no pain response: Group E = 81.5%, Group L = 77.8%, Group P = 14.8%) (P < 0.001). After intravenous administration of an intubating dose of rocuronium, the esmolol group had a significantly lower incidence of withdrawal movement than the other groups (no response: Group E = 81.5%, Group L = 63%, Group P = 22.2%) (P < 0.001).
  
  
  CONCLUSIONS
  We found that esmolol significantly attenuates rocuronium-induced withdrawal movement and also reduces pain when used at subparalyzing doses.
authors.forename: Jülide
authors.initials: J
authors.lastname: Ergil
authors.forename: Fatma
authors.initials: F
authors.lastname: Kavak Akelma
authors.forename: Derya
authors.initials: D
authors.lastname: Özkan
authors.forename: Gözde
authors.initials: G
authors.lastname: Bumin Aydin
authors.forename: Ayşe
authors.initials: A
authors.lastname: Gürel
authors.forename: Melih
authors.initials: M
authors.lastname: Akinci
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage; D000328:Adult; D000732:Androstanols / Q000008:administration & dosage / Q000009:adverse effects; D000768:Anesthesia, General / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D004311:Double-Blind Method; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control; D010147:Pain Measurement / Q000379:methods; D011412:Propanolamines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage; D000077123:Rocuronium; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D011412:Propanolamines; D008012:Lidocaine; C036604:esmolol; D000077123:Rocuronium; D015742:Propofol