The Use of Lidocaine for Preventing the Withdrawal Associated with the Injection of Rocuronium in Children and Adolescents

Shevchenko, Yuri; Jocson, Judith C.; McRae, Valerie A; Stayer, Stephen A.; Schwartz, Roy; Rehman, Mohamed A.; Choudhry, Dinesh K.

doi:10.1097/00000539-199904000-00011

Cited by 73 publications

(99 citation statements)

References 4 publications

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“…Bu amaçla lidokain, esmolol, ketamin, opioidler, deksmedotimidin, asetaminofen, nötralize edilmiş rokuronyum, dilüsyon metodu gibi tedavi modaliteleri denenmiştir. [2,[23][24][25][26] Bu çalışma bazı limitasyonlar içermektedir. Bunlar arasında uygulanan roküronyum dilüe edilmeden ve infüzyon pompası kullanılmadan IV verilmiştir.…”

Section: Tablo 2 Grupların çEkme Yanıt Skoru Dağılımıunclassified

The effect of Rocuronium Administration Rate And Remifentanil on The Prevention of Rocuronium Injection Pain in Pediatric Cases

Güneş²,

Ilgınel³

et al. 2017

Agri

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ÖzetAmaç: Bu çalışmada genel anestezi alması planlanan pediatrik olgularda yavaş ve hızlı rokuronyum enjeksiyonu öncesi uygulanan remifentanilin, hemodinamik değişiklikler ve rokuronyum enjeksiyon ağrısı üzerine olan etkisini belirlemeyi hedefledik. Gereç ve Yöntem: Çalışmamıza 5-15 yaş arasında, ASA I-II grubu 120 pediatrik hasta alındı. Birinci gruba (Grup A) rokuronyum yavaş enjeksiyonundan önce 4ml salin, ikinci gruba (Grup B) rokuronyum yavaş enjeksiyonundan önce 0,5µg kg-1 remifentanil, üçüncü gruba (Grup C) rokuronyum hızlı enjeksiyonundan önce 4ml salin, dördüncü gruba (Grup D) rokuronyum hızlı enjeksiyonundan önce 0,5µg kg-1 remifentanil verildi. Rokuronyum enjeksiyonu sırasında hastaların çekme yanıtları 0-3 puanlı çekme yanıt skoruna göre kaydedildi. Hemodinamik parametreler kaydedildi. Bulgular: Remifentanil yapılan gruplarda rokuronyum enjeksiyonu sonrası 1. dk' da plasebo yapılan gruplara göre kalp atım hızı ölçümleri daha düşük bulundu. Hastaların çekme yanıt skorları incelendiğinde yanıtsızlık oranının en yüksek olduğu gruplar B (%66.7) ve D grupları ( %70) idi. Yanıt olmayan hasta sayısı salin uygulanan A ve C gruplarında 9 iken, remifentanil uygulanan B grubunda 20, D grubunda 21 idi. Jeneralize yanıt ise en çok ( %20) A ve C gruplarında görüldü. Sonuç: Pediyatrik olgularda rokuronyuma bağlı gelişen enjeksiyon ağrısında enjeksiyon hızının etkisinin olmadığı, rokuronyum öncesi yapılan remifentanilin ciddi hemodinamik değişikliklere yol açmaksızın enjeksiyon ağrısını enjeksiyon hızı ile ilişki-siz olarak önemli oranda azalttığı kanısına varıldı.

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Section: Tablo 2 Grupların çEkme Yanıt Skoru Dağılımıunclassified

The effect of Rocuronium Administration Rate And Remifentanil on The Prevention of Rocuronium Injection Pain in Pediatric Cases

Güneş²,

Ilgınel³

et al. 2017

Agri

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“…These include diluting rocuronium, administering it as an infusion rather than as a bolus injection and the use of other medications like lignocaine (5) antiemetics, (6) antihistaminics, (7) short acting opioids (8) sodium bicarbonate, (9) ketamine, (10) dexmedetomidine, (11) and esmolol.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Efficacy of Sodium Bicarbonate and Lignocaine on Reducing Pain of Rocuronium Injection in Patients Undergoing General Anaesthesia

Christudas¹,

Parameswaran²,

Nimitha³

2017

jemds

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BACKGROUNDNeuro muscular blocking agents have been an essential part of anaesthesia for more than 50 years and commonly used for tracheal intubation and intra operative relaxation. Neuro muscular blockers can be classified as depolarizing agents e.g. Succinyl choline and non-depolarizing agents. Rocuronium a newer amino steroidal muscle relaxant with a rapid onset and intermediate duration of action can be used as an alternative to succinyl choline for intubation. (1) Pain during intravenous injection is the most commonly reported side effect of rocuronium Numerous techniques have been used to reduce the incidence and intensity of this pain. The se include diluting rocuronium, administering it as an infusion rather than as a bolus injection and the use of other medications like lignocaine, antiemetics, antihistaminics, short acting opioids, sodium bicarbonate, ketamine, dexmedetomidine and esmolol. MATERIALS AND METHODSThe study was conducted after obtaining approval of Research methodology and Human Ethical Committee of Government Medical College Trivandrum. Study population includes 120 adult patients of 18-60 years of age and of body weight 50-55 kg of ASA PS 1 & 2 posted for elective general surgery under general anaesthesia. Patients were divided into two equal groups of 60 each according to the order they come for surgery. Group A receives 0.5 ml of 7.5% sodium bicarbonate mixed with Inj. Rocuronium (50 mg). Group B receives 40 mg lignocaine mixed with Inj. Rocuronium (50 mg). Two intravenous lines with 18G IV cannula (One on the non-dominant hand and other on the dominant hand) were inserted and lactated ringers solution was infused at the rate of 100 ml/hr. After pre-oxygenation, a sleeping dose of IV thiopentone is given in the nondominant hand and once the consciousness is lost, the study drug (Freshly prepared) was injected over a period of 10 sec. in the dominant hand and patient was assessed for pain using the 4 point scale of limb withdrawal response. The heart rate and blood pressure response was also noted. Then 1.5 mg/kg preservative free lignocaine is given to both study groups followed by induction dose of Propofol 2.5 mg/kg and waited for 90 seconds. The ease of intubation was noted for both the study groups. Anaesthesia was maintained with nitrous oxide and oxygen (4:2), Inj. Fentanyl 2 µg/kg, Inj. Paracetamol 20 mg/kg IV and Inj. Propofol 75 µg/kg/min iv. The duration of action of Rocuronium was noted in both the studies by noting the time in minutes at which the patient comes out of the relaxant. Heart rate, the duration of action of Rocuronium was noted in both the studies by noting the time in minutes at which the patient comes out of the relaxant. Heart rate, systolic and diastolic blood pressure were recorded before the injection of the study drug, at the time of injection of the study drug, 1 min and 3 min after intubation. Within 24 hours after the operation, the injection site was checked for pain, oedema, wheal and flare response by an anaesthetist who was unaware of which...

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“…2 It is observed that the intravenous injection of rocuronium after the induction of anaesthesia is often associated with a localised withdrawal of the arm or generalised movement suggesting the presence of intense nociception, even during anaesthesia. 3,4,5,6,7 Such movements have been reported to be secondary to discomfort or pain at the site of injection in conscious patients. 8,9,10,11,12,13,14,15 Such spontaneous movements during induction can cause dislodgement of the intravenous catheter or rarely even pulmonary aspiration secondary to gastric regurgitation after generalised spontaneous movements during rocuronium injection.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment With Lidocaine for Preventing the Withdrawal Movements Associated With Intravenous Injection of Rocuronium - A Prospective, Double Blinded, Randomised and Placebo Control Study

Ranganath¹,

Gowda²

2016

jemds

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BACKGROUNDRocuronium has the fastest onset of action among the non-depolarising muscle relaxants. It is frequently used as an alternative to succinylcholine in situations in which rapid control of the airway is required and succinylcholine is contraindicated. It is observed that the intravenous injection of rocuronium after the induction of anaesthesia is often associated with a localised withdrawal of the arm or generalised movement; hence, this study was designed to find out that pain from injection of Rocuronium can be attenuated or abolished by previous administration of an intravenous local anaesthetic.

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The Use of Lidocaine for Preventing the Withdrawal Associated with the Injection of Rocuronium in Children and Adolescents

Abstract: Pain on injection of rocuronium in pediatric patients can be alleviated by pretreatment with i.v. lidocaine.

Cited by 73 publications

References 4 publications

The effect of Rocuronium Administration Rate And Remifentanil on The Prevention of Rocuronium Injection Pain in Pediatric Cases

The effect of Rocuronium Administration Rate And Remifentanil on The Prevention of Rocuronium Injection Pain in Pediatric Cases

Comparison of the Efficacy of Sodium Bicarbonate and Lignocaine on Reducing Pain of Rocuronium Injection in Patients Undergoing General Anaesthesia

Pretreatment With Lidocaine for Preventing the Withdrawal Movements Associated With Intravenous Injection of Rocuronium - A Prospective, Double Blinded, Randomised and Placebo Control Study

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