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http://dx.doi.org/10.4040/jkan.2009.39.2.270

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, Sung-Suk (Gil Medical Center)
Yoon, Hae-Sang (Department of Nursing, Gachon University of Medicine & Science)
Publication Information
Journal of Korean Academy of Nursing / v.39, no.2, 2009 , pp. 270-278 More about this Journal
Abstract
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.
Keywords
Muscle relaxants; Rocuronium; Pain; Injection;
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Times Cited By KSCI : 8  (Citation Analysis)
Times Cited By Web Of Science : 1  (Related Records In Web of Science)
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1 Jung, S. M., Ko, N. Y., Lim, Y. S., Kang, P. S., & Kwon, H. U. (2005). Comparison of premixed NaHCO3 and lidocaine on rocuronium injection pain. Korean Journal of Anesthesiology, 48, 483-488
2 Jung, S. S., Lee, J. N., & Yoon, S. H. (2005). Comparison of prevention effect of lidocaine preagreement on pain and withdrawal associated with injection of rocuronium. Korean Journal of Anesthesiology, 49, 131-135
3 Kwak, H. J., Lee, W. K., Kim, D. Y., & Kwak, H. S. (2004). Pain on injection of rocuronium: Influence of two methods of lidocaine injection. Korean Journal of Anesthesiology, 46, 675-678
4 Lee, S. K., Lee, J. M., Kim, Y. M., & Moon, H. S. (2004). Pain on injection of rocuronium: The effect of pretreatment of lidocaine, fentanyl, and ondansetron. Korean Journal of Anesthesiology, 46, 151-154
5 Robertson, E. N. (1996). Pain on administration of rocuronium. Anaesthesia, 51, 93   PUBMED
6 Robertson, E. N., Hull, J. M., Verbeek, A. M., & Booij, L. H. (1994). A comparison of rocuronium and vecuronium: The pharmacodynamic, cardiovascular and intra-ocular effects. European Journal of Anaesthesiology, 11(Suppl 9), 116-121   PUBMED
7 Ryoo, H. J. (2008, April). Specific practice of nurse anesthetist. Paper presented at the meeting of the Korean Nurse Anesthetists Association, Incheon
8 Steegers, M. A., & Robertson, E. F. (1996). Pain on injection of rocuronium bromide. Anesthesia and Analgesia, 83, 203   PUBMED
9 Shevchenko, Y., Jocson, J. C., McRae, V. A., Stayer, S. A., Schwartz, R. E., Rehman, M., et al. (1999). The use of lidocaine for preventing the withdrawal associated with the injection of rocuronium in children and adolescents. Anesthesia and Analgesia, 88, 746-748   DOI   ScienceOn
10 Moorthy, S. S., & Dierdorf, S. F. (1995). Pain on injection of rocuronium bromide. Anesthesia and Analgesia, 80, 1067   PUBMED
11 Kim, S. J., Lee, H. Y., & An, T. H. (2004). Comparison of withdrawal responses associated with temperature and gender on the injection of rocuronium. Korean Journal of Anesthesiology, 47, 331-335
12 Hwang, S. M., Oh, M. S., & Lim, S. Y. (2004). Effect of sodium bicarbonate or lidocaine mixed with rocuronium on withdrawal movement during rocuronium injection. Korean Journal of Anesthesiology, 46, 160-163
13 Blunk, J. A., Seifert, F., Schmelz, M., Reeh, P. W., & Koppert, W. (2003). Injection pain of rocuronium and vecuronium is evoked by direct activation of nociceptive nerve endings. European Journal of Anaesthesiology, 20, 245-253   DOI   ScienceOn
14 Lui, J. T., Huang, S. J., Yang, C. Y., Hsu, J. C., & Lui, P. W. (2002). Rocuronium induced generalized spontaneous movements cause pulmonary aspiration. Chang Gung Medical Journal, 25, 617-620   PUBMED
15 Jung, S. M., Kim, S. H., Lim, Y. S., Kwon, H. U., Kang, P. S., & Park, C. W. (2005). The effect of sodium bicarbonate or lidocaine mixed with rocuronium on withdrawal movement in pediatric patients. Korean Journal of Anesthesiology, 48, 514-519
16 Steegers, M., & Robertson, E. F. (1997). Pain on injection of rocuronium bromide. Anesthesia and Analgesia, 84, 228   PUBMED
17 Choi, H. G., Kim, D. S., Chang, T. H., Kim, S. H., Kim, K. H., & Ryu, S. J. (2006). Appropriate dosage of 8.4% sodium bicarbonate for preventing injection pain of rocuronium during anesthetic induction. Korean Journal of Anesthesiology, 51, 162-166   ScienceOn
18 Choi, J. H., Hwang, J. H., & Shin, Y. S. (2005). Comparison of the quantitative effect of ketamine on the vascular pain associated with intravenous rocuronium administration. Korean Journal of Anesthesiology, 49, 30-34
19 Martin, R., Carrier, J., Pirlet, M., Claprood, Y., & Tetrault, J. P. (1998). Rocuronium is the best nondepolarizing relaxant to prevent succinylcholine fasciculations and myalgia. Canadian Journal of Anaesthesia, 45, 521-525   DOI   ScienceOn
20 Booth, M. G., Marsh, B., Bryden, F. M., Robertson, E. N., & Baird, W. L. (1992). A comparison of the pharmacodynamics of rocuronium and vecuronium during halothane anaesthesia. Anaesthesia, 47, 832-834   DOI   ScienceOn
21 Memis, D., Turan, A., Karamanloglu, B., Sut, N., & Pamukcu, Z. (2002). The prevention of pain from injection of rocuronium by ondansetron, lidocaine, tramadol, and fentanyl. Anesthesia and Analgesia, 94, 1517-1520   DOI   PUBMED
22 Borgeat, A., & Kwiatkowski, D. (1997). Spontaneous movements associated with rocuronium: Is pain on injection the cause? British Journal of Anaesthesia, 79, 382-383   DOI   PUBMED   ScienceOn
23 Chiarella, A. B., Jolly, D. T., Huston, C. M., & Clanachan, A. S. (2003). Comparison of four strategies to reduce the pain associated with intravenous administration of rocuronium. British Journal of Anaesthesia, 90, 377-379   DOI   ScienceOn
24 Wee, S. Y., Lee, Y., An, T. H., So, G. Y., Lim, K. J., Jung, J. D., et al. (2004). The dose-dependent analgesic effect of lidocaine for pain on injecting rocuronium. Korean Journal of Anesthesiology, 47, 327-330
25 McCoy, E. P., Maddineni, V. R., Elliott, P., Mirakhur, R. K., Carson, I. W., & Cooper, R. A. (1993). Haemodynamic effects of rocuronium during fentanyl anaesthesia: Comparison with vecuronium. Canadian Journal of Anaesthesia, 40, 703-708   DOI   ScienceOn
26 Klement, W., & Arndt, J. O. (1991). Pain on intravenous injection of some anaesthetic agents is evoked by the unphysiological osmolality or pH of their formulations. British Journal of Anaesthesia, 66, 189-195   DOI   ScienceOn
27 Mencke, T., Beerhalter, U., & Fuchs-Buder, T. (2001). Spontaneous movements, local reactions and pain on injection of rocuronium. A comparison between female and male patients. Acta Anaesthesiologica Scandinavica, 45, 1002-1005   DOI   ScienceOn