Combination of nitrous oxide and lidocaine to prevent withdrawal after rocuronium in children.
10.4097/kjae.2010.58.5.446
- Author:
Hyun Jeong KWAK
1
;
Yun Jeong CHAE
;
Sook Young LEE
;
Young Jun KIM
;
Jong Yeop KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Lidocaine;
Nitrous oxide;
Rocuronium;
Withdrawal
- MeSH:
Androstanols;
Anesthesia;
Arm;
Child;
Double-Blind Method;
Forearm;
Humans;
Incidence;
Lidocaine;
Nitrous Oxide;
Oxygen;
Prospective Studies;
Thiopental
- From:Korean Journal of Anesthesiology
2010;58(5):446-449
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Pain at the site of rocuronium injection is a common side-effect in pediatric patients. This prospective, randomized, double-blind study evaluated the efficacy of a combination of nitrous oxide and lidocaine pretreatment on withdrawal response during rocuronium injection in children. METHODS: Sixty six pediatric patients, ages 5 to 12 years, were randomly assigned to two groups. The oxygen group received 100% oxygen, and the nitrous oxide group received 50% N2O in oxygen over 2 min. After anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and manual occlusion of the forearm was performed, 1% lidocaine 1 mg/kg was injected over 15 sec. After the occlusion was released, 0.1% rocuronium 0.6 mg/kg was injected over 5 sec. Patient response to rocuronium injection was graded using a 4-point scale. RESULTS: Overall incidence of withdrawal movements was significantly lower in the nitrous oxide group (1 patients; 3.1%) than in the oxygen group (8 patients; 25.8%) (P = 0.013). No patient in the nitrous oxide group displayed arm or generalized movement (grade 3 or 4) associated with rocuronium injection. CONCLUSIONS: This study demonstrated that a combination of inhaled 50% N2O in O2 and 1 mg/kg lidocaine pretreatment significantly reduced the incidence of rocuronium-induced withdrawal movements in pediatric patients compared with lidocaine pretreatment alone.
