A comparison of the efficacies of different pre-treatment drugs in resolving the injection pain of rocuronium

Abstract

Efficacies of pre-treatment with lidocaine, remifentanil and metoclopramide in the reduction of pain and withdrawal movements induced by rocuronium injection were evaluated. Forty-four adult patients, American Society of Anesthesiologists (ASA) Physical Status I - II, undergoing elective surgery were randomly assigned to four groups. Each patient received intravenously either 10 mg metoclopramide, 50 mg lidocaine, 1 μg/kg remifentanil or 3 ml of 0.9% sodium chloride (control group); followed by occlusion with a tourniquet on the forearm. After 10 s, occlusion stopped and a priming dose of 0.06 mg/kg rocuronium was injected. The patient's response to rocuronium was graded using a four-point scale in a double-blind manner. All groups had significantly lower incidences of pain compared with the control group. After loss of consciousness with sodium thiopental, 0.6 mg/kg rocuronium was administered for intubation and withdrawal movements were assessed. The number of patients in whom withdrawal movements were lowest was in the lidocaine-treated group. Although there was no difference among the study drugs in the prevention of rocuronium-induced pain, lidocaine and remifentanil seemed to be clinically more effective than metoclopramide. Copyright © 2006 Cambridge Medical Publications.