title: Rocuronium Bromide Inhibits Inflammation and Pain by Suppressing Nitric Oxide Production and Enhancing Prostaglandin E2Synthesis in Endothelial Cells.
abstract: OBJECTIVE
  Rocuronium bromide is a nondepolarizing neuromuscular blocking drug and has been used as an adjunct for relaxation or paralysis of the skeletal muscles, facilitation of endotracheal intubation, and improving surgical conditions during general anesthesia. However, intravenous injection of rocuronium bromide induces injection pain or withdrawal movement. The exact mechanism of rocuronium bromide-induced injection pain or withdrawal movement is not yet understood. We investigated whether rocuronium bromide treatment is involved in the induction of inflammation and pain in vascular endothelial cells.
  
  
  METHODS
  For this study, calf pulmonary artery endothelial (CPAE) cells were used, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, Western blot, nitric oxide detection, and prostaglandin E2immunoassay were conducted.
  
  
  RESULTS
  Rocuronium bromide treatment inhibited endothelial nitric oxide synthase and suppressed nitric oxide production in CPAE cells. Rocuronium bromide activated cyclooxygenase-2, inducible nitric oxide synthase and increased prostaglandin E2synthesis in CPAE cells.
  
  
  CONCLUSIONS
  Rocuronium bromide induced inflammation and pain in CPAE cells. Suppressing nitric oxide production and enhancing prostaglandin E2synthesis might be associated with rocuronium bromide-induced injection pain or withdrawal movement.
authors.affiliation: Department of Psychiatry, Ulsan University Gangneung Asan Hospital, College of Medicine, Ulsan University, Gangneung, Korea.
authors.forename: Sang Bin
authors.identifier: 0000-0001-5346-5512
authors.initials: SB
authors.lastname: Baek
authors.affiliation: School of Global Sport Studies, Korea University, Sejong, Korea.
authors.forename: Mal Soon
authors.identifier: 0000-0002-7462-2211
authors.initials: MS
authors.lastname: Shin
authors.affiliation: Department of Anesthesiology and Pain Medicine, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Jin Hee
authors.identifier: 0000-0003-0399-1148
authors.initials: JH
authors.lastname: Han
authors.affiliation: Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University , Seoul, Korea.
authors.forename: Sang Woong
authors.identifier: 0000-0003-4205-1730
authors.initials: SW
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Boksoon
authors.identifier: 0000-0003-1623-2685
authors.initials: B
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Jung Won
authors.identifier: 0000-0003-3087-086X
authors.initials: JW
authors.lastname: Jeon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Jae Woo
authors.identifier: 0000-0001-6474-5624
authors.initials: JW
authors.lastname: Yi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Jun Young
authors.identifier: 0000-0002-3517-249X
authors.initials: JY
authors.lastname: Chung
keywords: Cyclooxygenase 2; Endothelial Cells; Nitric Oxide; Prostaglandin E2; Rocuronium