The effect of various dilute administration of rocuronium bromide on both vascular pain and pharmacologic onset: a randomized controlled trial

Abstract

Background Rocuronium bromide (RB) is known to cause vascular pain. Although there have been a few reports that diluted administration causes less vascular pain, there have been no studies investigating diluted administration and the onset time of muscle relaxation. Therefore, we examined the influence of diluted administration of RB on the onset time of muscle relaxation and vascular pain. Methods 39 patients were randomly assigned to three groups: RB stock solution 10 mg/ml (Group 1), two-fold dilution 5 mg/ml (Group 2), or three-fold dilution 3.3 mg/ml (Group 3). After the largest vein of the forearm was secured, anesthesia was induced by propofol and 0.6 mg/kg of RB was administered. The evaluation method devised by Shevchenko et al. was used to evaluate the degree of vascular pain. The time from RB administration until the maximum blocking of T1 by TOF stimulation was measured. Results There was no significant difference in escape behaviors of vascular pain among the three groups, and the onset time of muscle relaxation was significantly slower in Group 3 than in Group 1 ( p = 0.033). Conclusion Our results suggested that it is unnecessary to dilute RB before administration if a large vein in the forearm is used. Trial registration UMINCTR Registration number UMIN000026737 . Registered 29 Mar 2017.

Median Effective Dose of Remifentanil for the Prevention of Pain Caused by the Injection of Rocuronium: An Age-Stratified Study

“…The stimulation on chemoreceptors by the pH and osmotic pressure of the rocuronium solution can cause painful sensations at the injection site [ 9 ]. Kanazawa et al [ 10 ] discovered that diluted rocuronium is effective in alleviating injection pain when administered through dorsal digital veins, which indicated that rocuronium-induced injection pain might be related to the intensity of drug stimulation on the vessels’ wall. Furthermore, rocuronium may permeate through the vascular wall to surrounding tissues, promoting histamine to be released, and creating local swelling and pain, as well as stimulating local nerve terminals to induce signal transduction, and generating central pain perception [ 11 ].…”