Remifentanil Prevents Withdrawal Movements Caused by Intravenous Injection of Rocuronium
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Purpose: The incidence of pain induced withdrawal movement following intravenous injection of rocuronium is high. This randomized, double-blind, placebo-controlled study was designed to evaluate the effect of pretreatment of remifentanil on the withdrawal movements due to intravenous injection of rocuronium during anesthetic induction. Materials and Methods: Ninety adult female patients undergoing thyroidectomy were randomly allocated to three groups. Each patient intravenously received one of three solutions of equal volume (4mL): normal saline (Group I, n=30), 0.5μg/kg remifentanil (Group II, n=30) or 1μg/kg remifentanil (Group III, n=30). Thirty seconds after remifentanil administration, anesthesia was induced with 5mg/kg IV thiopental. Twenty seconds after thiopental injection, 0.6mg/kg IV rocuronium was administered (injection rate of 0.5mL/sec) and patients’ withdrawal movements were assessed. Mean arterial pressure (MAP) and heart rate were assessed on arrival in the operation room, before the tracheal intubation and immediately, 1 and 2 min after the tracheal intubation. Results: The incidence of withdrawal movements was significantly lower in both of the remifentanil groups (3 and 0% in Group II and III, respectively) than in the saline group (70%). Remifentanil attenuated the increase of heart rate and MAP immediately and 1 min after the tracheal intubation. Conclusion: The pretreatment with 0.5 and 1.0μg/kg remifentanil of bolus doses prevented the withdrawal movements caused by rocuronium injection, and effectively blunted cardiovascular activation following tracheal intubation.
Abstract
Purpose: The incidence of pain induced withdrawal movement following intravenous injection of rocuronium is high. This randomized, double-blind, placebo-controlled study was designed to evaluate the effect of pretreatment of remifentanil on the withdrawal movements due to intravenous injection of rocuronium during anesthetic induction. Materials and Methods: Ninety adult female patients undergoing thyroidectomy were randomly allocated to three groups. Each patient intravenously received one of three solutions of equal volume (4mL): normal saline (Group I, n=30), 0.5μg/kg remifentanil (Group II, n=30) or 1μg/kg remifentanil (Group III, n=30). Thirty seconds after remifentanil administration, anesthesia was induced with 5mg/kg IV thiopental. Twenty seconds after thiopental injection, 0.6mg/kg IV rocuronium was administered (injection rate of 0.5mL/sec) and patients’ withdrawal movements were assessed. Mean arterial pressure (MAP) and heart rate were assessed on arrival in the operation room, before the tracheal intubation and immediately, 1 and 2 min after the tracheal intubation. Results: The incidence of withdrawal movements was significantly lower in both of the remifentanil groups (3 and 0% in Group II and III, respectively) than in the saline group (70%). Remifentanil attenuated the increase of heart rate and MAP immediately and 1 min after the tracheal intubation. Conclusion: The pretreatment with 0.5 and 1.0μg/kg remifentanil of bolus doses prevented the withdrawal movements caused by rocuronium injection, and effectively blunted cardiovascular activation following tracheal intubation.
참고문헌 (21)
- Steegers MA, "Robertson EN. Pain on injection of rocuronium bromide", Anesth Analg, 83, pp.203~ (1996)
- Borgeat A, "Spontaneous movements associated with rocuronium: is pain on injection the cause?", Br J Anaesth, 79, pp.382~383 (1997)
- Morishima T, "Profound pain due to propofol injection triggered myocardial ischemia in a patient with a suspected pheochromocytoma", Anesth Analg, 96, pp.631~ (2003)
- Cheong KF, "Pain on injection of rocuronium: influence of two doses of lidocaine pretreatment", Br J Anaesth, 84, pp.106~107 (2000)
- Memiş D, "The prevention of pain from injection of rocuronium by ondansetron, lidocaine, tramadol, and fentanyl", Anesth Analg, 94, pp.1517~1520 (2002)
- Reddy MS, "Effect of ondansetron pretreatment on pain after rocuronium and propofol injection: a randomised, double-blind controlled comparison with lidocaine", Anaesthesia, 56, pp.902~905 (2001)
- Ramaswamy S, "Analgesic effect of metoclopramide and its mechanism", Life Sci, 38, pp.1289~1292 (1986)
- Turan A, "The prevention of pain from injection of rocuronium by magnesium sulphate, lignocaine, sodium bicarbonate and alfentanil", Anaesth Intensive Care, 31, pp.277~281 (2003)
- Mahajan R, "Pain on injection of rocuronium: influence of ketamine pretreatment", Can J Anaesth, 52, pp.111~112 (2005)
- Chiarella AB, "Comparison of four strategies to reduce the pain associated with intravenous administration of rocuronium", Br J Anaesth, 90, pp.377~379 (2003)
- Tuncali B, "Dilution of rocuronium to 0.5mg", mL with 0.9% NaCl eliminates the pain during intravenous injection in awake patients, 2004, pp.99, 740~743
- Egan TD, "Remifentanil pharmacokinetics and pharmacodynamics. A preliminary appraisal", Clin Pharmacokinet, 29, pp.80~94 (1995)
- Egan TD, "Remifentanil versus alfentanil: comparative pharmacokinetics and pharmacodynamics in healty adult male volunteers", Anesthesiology, 84, pp.821~833 (1996)
- Mazurek AJ, "Rocuronium versus succinylcholine: are they equally effective during rapid-sequence induction of anesthesia?", Anesth Analg, 87, pp.1259~1262 (1998)
- Borgeat A, "Spontaneous movements associated with rocuronium injection: the effects of prior administration of fentanyl", J Clin Anesth, 9, pp.650~652 (1997)
- Iyilikci L, "The effects of alfentanil or remifentanil pretreatment on propofol injection pain", J Clin Anesth, 16, pp.499~502 (2004)
- Höhne C, "Opioids during anesthesia in liver and renal failure", Anaesthesist, 53, pp.291~303 (2004)
- Bilgin H, "A comparison of effects of alfentanil, fentanyl, and remifentanil on hemodynamic and respiratory parameters during stereotactic brain biopsy", J Neurosurg Anesthesiol, 18, pp.179~184 (2006)
- Hall AP, "Comparison of different doses of remifentanil on the cardiovascular response to laryngoscopy and tracheal intubation", Br J Anaesth, 84, pp.100~102 (2000)
- Shevchenko Y, "The use of lidocaine for preventing the withdrawal associated with the injection of rocuronium in children and adolescents", Anesth Analg, 88, pp.746~748 (1999)
- Mencke T, "Spontaneous movements, local reactions and pain on injection of rocuronium. A comparison between female and male patients", Acta Anaesthesiol Scand, 45, pp.1002~1005 (2001)