Comparison of Premixed NaHCO<sub>3</sub>and Lidocaine on Rocuronium Injection Pain

Jung, Sung Mee; Ko, Na Young; Lim, Yoongho; Kang, Po Soon; Kwon, Hee Uk

doi:10.4097/kjae.2005.48.5.483

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…summarizes the characteristics of the 61 studies that met the inclusion criteria. The pharmacological strategies used to prevent RIPR or RIWR consisted of lidocaine (Lido) [4, 10-22, 27, 67-82, 82, 84-91], fentanyl (Fent) [4, 14,23,67,75,82,88], oxycodone (Oxyc) [92], deketoprofen [93], dexmedetomidine (Dexm) [10,11], a combination of dexmedetomidine and lidocaine (Dexm + Lido) [10], gabapentin (Gaba) [9,94], N 2 O [12,25,95], a combination of lidocaine and N 2 O (Lido + N 2 O) [12,16], remifentanil (Remi) [70,72,96], alfentanil (Alfe) [27,74,96], nafamostat mesilate [97], peniramine (Peni) [24], normal saline dilution (NS_dilu) [5, [98][99][100][101][102][103][104], rocuronium mixed with lidocaine (Lido_mix) [5,54], ondansetron (Onda) [14,85,88,91,105], tramadol (Tram) [14,21,91], thiopental (Thio) …”

Section: Study Selectionmentioning

confidence: 99%

“…Twenty-eight loops were closed in the network generated from the comparison of the withdrawal response in adults, but six loops (Cont-Keto-Lido + Keto [71], NS_dilu-Sobi_mix-Lido + Sobi [98], and Lido_mix-Sobi_mix-Lido + Sobi [98]) consisted of only multi-arm trials. Although most loops showed no significance in the local inconsistency between the direct and indirect point estimates, two loops (Lido-Remi-Alfe and Lido-Dexm-Dexm + Lido) showed significant inconsistency (Fig.…”

Section: Rocuronium-induced Withdrawal Responsementioning

confidence: 99%

“…There were 43 closed loops in the network generated from the comparisons of the pain response in adults, but 10 loops (Cont-Sobi-MgSO 4 [27], Cont-Sobi-Alfe [27], Cont-MgSO 4 -Alfe [27], Lido-Sobi-MgSO 4 [27], Lido-MgSO 4 -Alfe [27], Lido-Sobi-Alfe [27], Sobi-MgSO 4 -Alfe [27], NS_dilu-Lido_mix-Lido + Sobi_mix [98], Sobi_mix-Lido_mix-Lido + Sobi [98], and Sufe-Tram-Mepe [21]) consisted of only multi-arm trials. All loops showed no significance in the local inconsistency between the direct and indirect point estimates (Fig.…”

Section: Rocuronium-induced Pain Responsementioning

confidence: 99%

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Pharmacological interventions for preventing rocuronium-induced pain responses and rocuronium-induced withdrawal responses: a systematic review and network meta-analysis

2020

Signa Vitae

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Study objective: Rocuronium is widely used during the induction of general anesthesia. However, it is associated with rocuronium-induced pain response, which can appear as a rocuronium-induced withdrawal response. The purpose of this study was to compare the effectiveness of pharmacological interventions in preventing rocuronium-induced pain response and rocuronium-induced withdrawal response using a network meta-analysis. Design: Systematic review and network meta-analysis (NMA) of RCTs. Setting: Pharmacological interventions to prevent rocuronium-induced pain response and rocuronium-induced pain response and rocuronium-induced withdrawal. Data sources: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar were systematically searched from its inception until Mar 2020. Methods: We searched multiple databases and extracted randomized controlled trials that compared two or more pharmacological interventions to prevent rocuronium-induced pain response and rocuronium-induced withdrawal response in adult patients who received rocuronium injections for general anesthesia. We conducted network meta-analysis and used surface under the cumulative ranking curve values and rankograms to present the hierarchy of the pharmacological interventions evaluated. Results: In total, 43 studies (5,291 patients) were included in this network meta-analysis and 31 pharmacological interventions were evaluated. The rankogram and cumulative ranking plot showed that oxycodone followed by a combination of lidocaine and sodium bicarbonate (NaHCO3), esmolol, alfentanil, and rocuronium mixed with NaHCO3 had the lowest frequency of rocuronium-induced withdrawal response. In terms of rocuronium-induced pain response, NaHCO3 mixed with rocuronium showed the lowest frequency, followed by a combination of lidocaine and NaHCO3, a combination of lidocaine and nitrous oxide, rocuronium mixed with lidocaine, and lidocaine. Conclusions: Lidocaine administration has been shown to reduce the incidence of rocuronium-induced pain response regardless of the method of injection or drug combination. The combination of lidocaine and NaHCO3 or mixing NaHCO3with rocuronium was effective at reducing rocuronium-induced withdrawal response. In particular, oxycodone was shown to be more effective than the other opioids evaluated and esmolol was also found to be effective at reducing rocuronium-induced withdrawal response.

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Section: Study Selectionmentioning

confidence: 99%

Section: Rocuronium-induced Withdrawal Responsementioning

confidence: 99%

Section: Rocuronium-induced Pain Responsementioning

confidence: 99%

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Pharmacological interventions for preventing rocuronium-induced pain responses and rocuronium-induced withdrawal responses: a systematic review and network meta-analysis

2020

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Pharmacological and non-pharmacological interventions for reducing rocuronium bromide induced pain on injection in children and adults

Prabhakar

Singh

Ali³

et al. 2016

Cochrane Database of Systematic Reviews

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A Comparison of the Effect of Lidocaine or Sodium Bicarbonate Mixed with Rocuronium on Withdrawal Movement, Mean Arterial Pressure and Heart Rate during Rocuronium Injection

Lee

Yoon

2009

J Korean Acad Nurs

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Purpose: This study was performed to find out the effects of lidocaine or 8.4% sodium bicarbonate mixed with rocuronium on mean arterial pressure, heart rate and withdrawal movement. Methods: Data collection was performed from December 15, 2006 through May 31, 2007. Seventy-five patients with American Society Anesthesiologist (ASA) physical status I & II, under general anesthesia, were randomly assigned to 1 of 3 groups: R group (RG) received rocuronium 0.6 mg/kg; RL group (RLG), rocuronium 0.6 mg/kg mixed with 2 mL of 2% lidocaine; RS group (RSG), rocuronium 0.6 mg/kg with the same volume of 8.4% sodium bicarbonate. Mean arterial pressure, heart rate and withdrawal movement were observed from its injection until 5 min after endotracheal intubation. Results: The incidence of withdrawal movement with its corresponding injections was 72%, 40% and 4% in RG, RLG and RSG, respectively (p<.001). Score of withdrawal movement was the lowest in RSG of all groups (p<.001). While mean arterial pressure (p=.011) in RSG decreased significantly, and heart rate (p=.003) in RG increased more with its injection than before induction of anesthesia. Conclusion: Administration of the equivalent volume of 8.4% sodium bicarbonate with rocuronium is more effective than that of lidocaine with rocuronium compared with rocuronium only, in preventing withdrawal movement and in stabilizing mean arterial pressure and heart rate.

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Comparison of Premixed NaHCO₃and Lidocaine on Rocuronium Injection Pain

Cited by 4 publications

References 22 publications

Pharmacological interventions for preventing rocuronium-induced pain responses and rocuronium-induced withdrawal responses: a systematic review and network meta-analysis

Pharmacological interventions for preventing rocuronium-induced pain responses and rocuronium-induced withdrawal responses: a systematic review and network meta-analysis

Pharmacological and non-pharmacological interventions for reducing rocuronium bromide induced pain on injection in children and adults

A Comparison of the Effect of Lidocaine or Sodium Bicarbonate Mixed with Rocuronium on Withdrawal Movement, Mean Arterial Pressure and Heart Rate during Rocuronium Injection

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Comparison of Premixed NaHCO3and Lidocaine on Rocuronium Injection Pain

Cited by 4 publications

References 22 publications

Pharmacological interventions for preventing rocuronium-induced pain responses and rocuronium-induced withdrawal responses: a systematic review and network meta-analysis

Pharmacological interventions for preventing rocuronium-induced pain responses and rocuronium-induced withdrawal responses: a systematic review and network meta-analysis

Pharmacological and non-pharmacological interventions for reducing rocuronium bromide induced pain on injection in children and adults

A Comparison of the Effect of Lidocaine or Sodium Bicarbonate Mixed with Rocuronium on Withdrawal Movement, Mean Arterial Pressure and Heart Rate during Rocuronium Injection

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Comparison of Premixed NaHCO₃and Lidocaine on Rocuronium Injection Pain