Spontaneous movements, local reactions and pain on injection of rocuronium

Mencke, Thomas; Beerhalter, U.; Fuchs‐Buder, Thomas

doi:10.1034/j.1399-6576.2001.450813.x

Cited by 50 publications

(32 citation statements)

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“…Withdrawal rates after injection were between 15 and 35% in our study. These rates are similar with the rates reported in the literature (12-28%) (15,18). The fact that no significant difference was observed in hand withdrawal rates between lidocaine and 0.9% NaCl groups during or after injection support our opinion that 0.9% NaCl use should be preferred.…”

Section: Discussionsupporting

confidence: 81%

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Comparison of the Effect of Different Concentrations of Rocuronium on Injection Pain and Haemodynamics Using Isolated Forearm Technique

Erbabacan¹,

Köksal²,

Tütüncü³

et al. 2013

Turk J Anesth Reanim

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Objective: We aimed to evaluate Visual-Analogue-Scale (VAS) scores, hand-withdrawal, rash and skin eruptions after injections of different concentrations of rocuronium in intubation doses in alert patients using the isolated-forearm technique.Methods: Eighty ASA I-II patients were included in a randomized, controlled, single-blinded study. Two 20 G cannulas were inserted into the dorsum of the left and right hand in each patient. A tourniquet was applied to the left arm and inflated to 50 mm Hg above the patient's systolic blood pressure. Group 1 (n=20) received 2.5 mg mL -1 rocuronium diluted with 0.9% NaCl, Group 2 (n=20) received 5 mg mL -1 rocuronium diluted with 0.9% NaCl, Group 3 (n=20) received 10 mg mL -1 rocuronium and 0.4 mg mL -1 lidocaine mixture, and Group 4 (n=20) received 10 mg mL -1 rocuronium via a cannula on the left hand, provided that a dose of 0.6 mg mL -1 were given to all groups of patients. VAS 0 -VAS 60 values, hand-withdrawal, rash and skin eruptions were assessed in patients who were administered rocuronium but not under the effects of hypnotic or neuromuscular agents. Hemodynamic values were recorded both before and after the administration of hypnotic-neuromuscular agents.Results: VAS0 values were significantly higher in Group 4 when compared to Groups 1, 2 and 3 (p=0.032). No significant difference was observed between VAS0 and VAS60 values in Groups 1, 2 and 3. In Group 4, VAS 0 values were significantly higher than VAS 60 values (p=0.003). No significant difference was observed between groups in terms of side effects and hemodynamic values. Conclusion:In conclusion, we determined that using rocuronium diluted with 0.9% NaCl was more effective in preventing injection pain than using a rocuronium-lidocaine mixture.Key Words: Rocuronium, intravenous injection, pain AbstractThe patient was transferred to the operating room, and two 20-gauge cannulas were placed at the back of the patient's right and left hands at one attempt without causing any hematoma and 4 mL kg -1 of 0.9% NaCl infusion was started from the right hand. Age, weight and gender of the patients were recorded, and as a standard procedure ECG, SpO 2 , non-invasive arterial pressure monitoring was performed (Datex Ohmeda S/5 Avance) in the operating room. Patients were randomized into 4 groups. Group 1 (n=20) received 2.5 mg mL -1 rocuronium diluted with 0.9% NaCl, Group 2 (n=20) received 5 mg mL -1 rocuronium diluted with 0.9% NaCl, Group 3 (n=20) received a mixture of 10 mg mL -1 rocuronium and 0.4 mg mL -1 lidocaine, and Group 4 (n=20) received 10 mg mL -1 rocuronium, providing a total dose of 0.6 mg kg -1 in all groups. No analgesics were administered before rocuronium application. Drugs were prepared in 20 mL syringes by an anaesthetist other than the anaesthetist who would administer the drug. In order to provide double blind testing, the syringes were covered with a non-transparent foil in order to keep the anaesthetist who administered the drug, unaware about the concentration and content of the drug.In order to p...

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Section: Discussionsupporting

confidence: 81%

“…Mencke et al (18), reported the percentage of hand withdrawal approximately 22% after pure rocuronium injection. Withdrawal rates after injection were between 15 and 35% in our study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effect of Different Concentrations of Rocuronium on Injection Pain and Haemodynamics Using Isolated Forearm Technique

Erbabacan¹,

Köksal²,

Tütüncü³

et al. 2013

Turk J Anesth Reanim

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“…On the other hand, females may experience respiratory depression more often and other adverse eff ects more easily if they are given the same opioid doses as males. Though not associated with adverse clinical consequences for the patient's outcome, the incidence and the degree of pain and withdrawal reactions in response to the injection of rocuronium is significantly higher in women than in men 11 . The same implies for precurarization dose of rocuronium 12 .…”

Section: Discussionmentioning

confidence: 99%

Influence of Gender on the Onset and Duration of Rocuronium-Induced Neuromuscular Block

Adamus¹,

Koutná²,

Gabrhelík³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims:To assess the infl uence of gender on the course of rocuronium-induced neuromuscular block following a single bolus dose of 2 × ED 95 (0.6 mg kg -1 ). Methods: Following the ethics committee approval and informed consent, 245 patients (121 men, 124 women) scheduled for elective general surgery under TIVA with muscle relaxation were studied. After rocuronium 0.6 mg kg -1 , the onset time for maximal depression of T 1 , clinical duration until 25 % recovery and recovery index (T 1 from 25 to 75 %) were determined with TOF-Watch ® SX accelerometric monitor. The data for male and female groups were compared with appropriate statistical tests (Student's unpaired t-test, Mann-Whitney Rank Sum Test and Fisher's exact test).Results: Men were signifi cantly larger (p < 0.001) and heavier (p < 0.05) than women, but the body mass index was comparable (ns). Conclusions: Women are more sensitive than men to the dose 0.6 mg kg -1 of rocuronium. Under the study conditions described, the onset time was shortened and the clinical duration increased in female patients. This suggests that the routine dose of rocuronium should be reduced in women.

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“…무의식 상태에서 통증으로 나타나는 신체반응으로 (Mencke et al, 2001;Robertson, 1996) O1=blood pressure, heart rate, pain; O2=blood pressure, heart rate, withdrawal movement; O3, O4, O5=blood pressure, heart rate; X1=administration of lidocaine and rocuronium; X2=administration of 8.4% sodium bicarbonate and rocuronium; X3=administration of rocuronium. (Table 4) …”

Section: ) 회피반응mentioning

confidence: 99%

“…Borgeat과 Kwiatkowski (1997) Rocuronium 정맥주사 시의 통증으로 평균 동맥압과 심박수 가 상승하며 (Booth, Marsh, Bryden, Robertson, & Baird, 1992;Robertson, 1996) 통증은 에피네프린 및 노르에피네프 린의 분비를 자극하는 것은 이미 널리 알려진 사실이다. 의식 상 태에서 rocuronium 정맥주사 동안에 나타나는 통증 반응이 무 의식 상태에서는 손이나 다리의 움직임으로 나타나는데 이러한 현상을 회피반응이라고 한다 (Mencke et al, 2001;Robertson, 1996). 회피반응은 rocuronium 투여 환자의 50-80%에 서 발생하며 회피반응 시의 움직임으로 약물의 정맥 투여가 어 렵거나 낙상을 하거나 폐 흡인을 초래하여 위험하다 (Borgeat & Kwiatkowski, 1997;Lui, Huang, Yang, Hsu, & Lui, 2002 (Chiarella et al, 2003;Choi, Hwang, & Shin, 2005;Memis, Turan, Karamanloglu, Sut, & Pamukcu, 2002 (Jung, Lee, & Yoon, 2005;Lee, Lee, Kim, & Moon, 2004;Wee et al, 2004).…”

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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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Spontaneous movements, local reactions and pain on injection of rocuronium

Abstract: The incidence and the degree of withdrawal reactions in response to the injection of rocuronium were significantly higher in women than in men. This was not associated with adverse clinical consequences for the patient's outcome.

Cited by 50 publications

References 21 publications

Comparison of the Effect of Different Concentrations of Rocuronium on Injection Pain and Haemodynamics Using Isolated Forearm Technique

Comparison of the Effect of Different Concentrations of Rocuronium on Injection Pain and Haemodynamics Using Isolated Forearm Technique

Influence of Gender on the Onset and Duration of Rocuronium-Induced Neuromuscular Block

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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