Women report more pain on injection of a precurarization dose of rocuronium: A randomized, prospective, placebo‐controlled trial

Abstract

Women experienced more pain on injection of rocuronium than men, moreover this is an additional evidence for gender-related differences in pain perception. When rocuronium is used as a precurarization agent, an analgesic pretreatment (e.g. opioids) should be considered, especially for female patients.

Neutralized rocuronium (pH 7.4) before administration prevents injection pain in awake patients: a randomized prospective trial

“…This finding is consistent with the results of Chiarella et al [21] and Turan et al [22]. Mencke et al [7] and Tuncali et al [8] showed that rocuronium diluted with saline decreased injection pain significantly. However, in our study, there were no differences between the saline-mixed group (group 2) and the rocuronium only group (group 1).…”

“…Some studies have reported that prior administration of lidocaine or fentanyl reduces rocuronium injection pain [4][5][6]. In recent studies with awake patients who received no pretreatment with local anesthetics or opioid, normal saline mixtures decreased rocuronium injection pain because of a dilution effect [7,8]. Dexmedetomidine [9], ketamine [10], and thiopental sodium [11] pretreatments also reduce pain on injection.…”

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

“…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 .…”

Esmolol pretreatment reduces the frequency and severity of pain on injection of rocuronium

“…Mencke et al [18] found a 33% incidence of pain using a precurarization dose of rocuronium of 0.03 mg/kg in 5 mL saline. We used a greater concentration, 0.05 mg/kg in 5 mL saline, and the frequency of pain was 63%.…”