Remifentanil Prevents Withdrawal Movements Caused by Intravenous Injection of Rocuronium.
10.3349/ymj.2008.49.2.211
- Author:
Byung In CHOI
1
;
Seung Ho CHOI
;
Yang Sik SHIN
;
Sung Jin LEE
;
Kyung Bong YOON
;
Seo Kyung SHIN
;
Ki Young LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. kylee504@yuhs.ac
- Publication Type:Original Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Remifentanil;
rocuronium;
withdrawal movements
- MeSH:
Adult;
Aged;
Analgesics, Opioid/administration & dosage/therapeutic use;
Androstanols/administration & dosage/*adverse effects;
Female;
Humans;
Injections, Intravenous/adverse effects;
Middle Aged;
Pain/etiology/*prevention & control;
Piperidines/administration & dosage/*therapeutic use
- From:Yonsei Medical Journal
2008;49(2):211-216
- CountryRepublic of Korea
- Language:English
-
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 (4 mL): normal saline (Group I, n=30), 0.5 microgram/kg remifentanil (Group II, n=30) or 1 microgram/kg remifentanil (Group III, n=30). Thirty seconds after remifentanil administration, anesthesia was induced with 5 mg/kg IV thiopental. Twenty seconds after thiopental injection, 0.6 mg/kg IV rocuronium was administered (injection rate of 0.5 mL/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 1.0 microgram/kg remifentanil of bolus doses prevented the withdrawal movements caused by rocuronium injection, and effectively blunted cardiovascular activation following tracheal intubation.
