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Rapid injection of rocuronium reduces withdrawal movement on injection

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Author(s)
Young Ho JangYong Cheol LeeJin Mo KimSang Gyu Lee
Keimyung Author(s)
Lee, Yong CheolJang, Young HoKim, Jin Mo
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
Journal of Clinical Anesthesia
Issued Date
2009
Volume
21
Issue
6
Keyword
Injection painLidocaine pretreatmentRocuronium injection painWithdrawal movementWithdrawal response
Abstract
Study Objective:

To test whether rapid injection of rocuronium reduces withdrawal movement on injection.


Design:

Randomized, prospective trial.


Setting:

Operating room in a university hospital.


Patients:

150 ASA physical status I and II patients aged 18 to 60 years, undergoing general anesthesia.


Interventions:

Patients were randomized to three groups. After undergoing anesthesia induction with thiopental sodium, then 5 seconds later receiving a rubber tourniquet applied to the mid-forearm to stop intravenous (IV) flow by gravity, the pretreatment drug was injected. The tourniquet was held for 15 seconds then released, and 1.0 mg/kg of 1% rocuronium was injected IV. Group C patients (n = 50) were pretreated with 0.1 mL/kg of 0.9% NaCl and then injected with rocuronium slowly within 10 seconds. Group L patients (n = 50) were pretreated with 0.1 mL/kg of preservative-free 1% lidocaine and then injected with rocuronium slowly within 10 seconds. Group R patients (n = 50) were pretreated with 0.1 mL/kg of 0.9% NaCl and then rapidly injected with rocuronium within approximately one second (as quickly as possible).


Measurements:

After injection of the patient with the study drug, a single anesthesiologist with no knowledge of the study protocol graded each patient's response as follows: 0 = no response; 1 = mild movement limited to the wrist only; 2 = moderate movement involving the elbow and shoulder; and 3 = severe movement involving more than one extremity.


Main Results:

Group C had the most intense and frequent withdrawal response. The frequency and intensity of withdrawal movement was significantly less in Groups L and R than Group C. No significant difference in withdrawal response between Groups L and R was noted.


Conclusions:

Withdrawal response can be significantly reduced for rocuronium injection without lidocaine pretreatment, simply through rapid injection.
Keimyung Author(s)(Kor)
이용철
장영호
김진모
Publisher
School of Medicine
Citation
Young Ho Jang et al. (2009). Rapid injection of rocuronium reduces withdrawal movement on injection. Journal of Clinical Anesthesia, 21(6), 427–430. doi: 10.1016/j.jclinane.2008.11.011
Type
Article
ISSN
0952-8180
Source
https://www.sciencedirect.com/science/article/pii/S0952818009002190?via%3Dihub
DOI
10.1016/j.jclinane.2008.11.011
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33976
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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