Comparison of Premixed NaHCO3 and Lidocaine on Rocuronium Injection Pain.
10.4097/kjae.2005.48.5.483
- Author:
Sung Mee JUNG
1
;
Na Young KO
;
Young Su LIM
;
Po Soon KANG
;
Hee Uk KWON
Author Information
1. Department of Anesthesiology and Pain Medicine, School of Medicine, Konyang University, Daejeon, Korea. applejsm@hotmail.com
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
lidocaine;
pain;
rocuronium;
sodium bicarbonate;
withdrawal movement
- MeSH:
Burns;
Humans;
Hydrogen-Ion Concentration;
Incidence;
Lidocaine*;
Muscle Relaxation;
Osmolar Concentration;
Prospective Studies;
Sodium Bicarbonate
- From:Korean Journal of Anesthesiology
2005;48(5):483-488
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Rocuronium administration is associated with a severe burning pain during injection in 50-80% patients. The purpose of this study was to evaluate mixtures of saline, lidocaine, sodium bicarbonate (NaHCO3) and lidocaine-NaHCO3 with rocuronium to reduce injection pain and withdrawal movement. METHODS: One hundred and twenty patients were randomly assigned to one of four groups in a double blinded, prospective study; Group S (0.9% normal saline 5 ml mixed with rocuronium 50 mg/5 ml, n = 30), Group L (2% lidocaine 5 ml mixed with rocuronium 50 mg/5 ml, n = 30), Group B (8.4% NaHCO3 5 ml mixed with rocuronium 50 mg/5 ml, n = 30) and Group LB (4% lidocaine 2.5 ml and 8.4% NaHCO3 2.5 ml mixed with rocuronium 50 mg/5 ml, n = 30). After all patients had received an intubating dose (0.6 mg/kg) of premixed rocuronium over 5 seconds, we investigated the incidence and severity of pain and withdrawal movement. We measured the onset and duration of muscle relaxation using train-of-four (TOF) and the pH values and osmolalities of each mixture. RESULTS: The incidence and severity of pain during injection were significantly reduced in Groups B and LB compared with Group S. The withdrawal movement was observed 8 patients (26.7%) in Group S, but in no patient in Groups B or LB. No significant difference in the incidence of pain or withdrawal response was observed between Groups S and L. CONCLUSIONS: We conclude that premixed NaHCO3 with rocuronium is effective at reducing injection pain and withdrawal movement whereas the addition of lidocaine has little effect.
