Pharmacological and non-pharmacological intervention for rocuronium-induced withdrawal movement in the Korean population: a meta-analysis of 41 studies including 4,742 subjects.
10.4097/kjae.2014.66.6.419
- Author:
Geun Joo CHOI
1
;
Sangseok LEE
;
Jeoung Hyuk LEE
;
Seul Gi PARK
;
Hyun KANG
Author Information
1. Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea. roman00@naver.com
- Publication Type:Meta-Analysis ; Original Article
- Keywords:
Anesthesia;
Injection;
Meta-analysis;
Pain;
Rocuronium;
Systematic review
- MeSH:
Analgesics, Opioid;
Anesthesia;
Hypnotics and Sedatives;
Incidence;
Lidocaine;
Outcome Assessment (Health Care);
Tourniquets
- From:Korean Journal of Anesthesiology
2014;66(6):419-432
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We purposed to systemically review studies investigating the prophylactic effect of both pharmacological and non-pharmacological modalities against rocuronium induced withdrawal movement (RIWM) in the Korean population. METHODS: Literature search was performed using MEDLINE, EMBASE, CENTRAL, Koreamed, KMBASE, KISS and RISS up to March 2014. Randomized controlled trials (RCTs) comparing pharmacological and non-pharmacological interventions with placebo aimed for the Korean population were included. Outcome measures were the incidence and severity of RIWM. We conducted subgroup analyses according to each intervention method. RESULTS: Data were analyzed from 41 RCTs totaling 4,742 subjects. The overall incidence of RIWM was about 80% (range 56-100%). Incidence and severity of RIWM were significantly reduced with lidocaine (risk ratio [RR] 0.60, 95% CI 0.49-0.74; standardized mean difference [SMD] -0.74, 95% CI -1.05 to -0.44), opioids (RR 0.28, 95% CI 0.18-0.44; SMD -1.71, 95% CI -2.09 to -1.34) and hypnotics (RR 0.36, 95% CI 0.25-0.52; SMD -2.20, 95% CI -2.62 to -1.79). Regardless of tourniquet use, lidocaine showed a prophylactic effect against incidence and severity of RIWM: tourniquet (RR 0.36, 95% CI 0.21-0.62; SMD -1.51, 95% CI -2.15 to -0.86); non-tourniquet (RR 0.58, 95% CI 0.47-0.71; SMD -0.74, 95% CI -1.05 to -0.44). Dilution and slow injection of rocuronium decreased incidence and severity of RIWM: dilution (RR 0.47, 95% CI 0.39-0.56; SMD -1.64, 95% CI -2.47 to -0.81); slow injection (RR 0.34, 95% CI 0.17-0.70; SMD -2.13, 95% CI -2.74 to -1.51). CONCLUSIONS: The greater part of pharmacological and non-pharmacological interventions showed prophylactic effect against the incidence and severity of RIWM in the Korean population.
