BACKGROUND: The main disadvantage of rocuronium is the pain associated with vascular injection. We evaluated the efficacy of palonosetron for reducing pain after rocuronium injection. METHODS: Eighty patients scheduled for elective surgery were randomly divided into two groups: Group C (normal saline 1.5 ml, n = 40) and Group P (palonosetron 0.075 mg, n = 40). Anesthesia was induced with thiopental 5 mg/kg and the test drug was injected over 10 seconds. Thirty seconds after the injection of the test drug, rocuronium 0.6 mg/kg was injected over 30 seconds and the response was recorded. Injection pain was graded using a 4-point scale. The grade was 0 points for no movement, 1 point for wrist movement, 2 points for elbow or shoulder movement, and 3 points for whole body movement. Mean arterial pressure and heart rate were recorded on arrival in the operating room and before and 30 seconds after rocuronim injection. RESULTS: There was no significant difference in the grade 1 response between the two groups; however, the grade 2 and 3 responses in Group P were 5 (12.5%) and 4 (10%), respectively, which were significantly lower than in Group C, with 13 (32.5%) responses for each grade. There were no significant differences in hemodynamic changes within each group. However, the difference in mean arterial pressure before and after the injection of rocuronium was significantly larger in Group C compared to Group P. CONCLUSIONS: Pretreatment with palonosetron 0.075 mg reduced the incidence and severity of withdrawal movement after rocuronium administration.
Anesthesia ; Arterial Pressure ; Elbow ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Operating Rooms ; Shoulder ; Thiopental ; Wrist

The best treatment modality for spontaneous intracerebral hemorrhage still remains to be controversial. Stereotactic surgery can be performed safely and easily but its indication and optimal timing of operation have to be determined. We treated 80 patients with spontaneous intracerebral hemorrhage by stereotactic surgery from October 1994 to December 1997. We investigated clinical status of the patients before and after surgery, amount of hematoma, evacuation rate, timing of operation, transcranial Doppler sonography(TCD), and computerized tomography(CT) findings. The results were as follows: 1) The outcome of early surgery(within 24 hours of bleeding) was better than that of late surgery(after 24 hours of bleeding)(p=0.034). 2) The outcome was better in the patient with higher evacuation rate(p=0.014). 3) TCD monitoring showed beneficial effect of surgery on hemodynamic status. We conclude that the early surgery within 24 hours after bleeding is correlated with the better outcome, and TCD monitoring is useful for evaluation of perioperative hemodynamic change.
Cerebral Hemorrhage* ; Hematoma ; Hemodynamics ; Hemorrhage ; Humans

Intraoperative formation and management of a thrombus in right atrium has been reported occasionally. Nevertheless, it is rare that a right atrial thrombus with unstable hemodynamic changes detected by transesophageal echocardiography is resolved spontaneously. We report upon the 44-year-old woman, who had a right atrial thrombus detected by transesophageal echocardiography during laparoscopic assisted vaginal hysterectomy and resolved during thromboembolectomy.
Adult ; Echocardiography, Transesophageal ; Female ; Heart Atria ; Hemodynamics ; Humans ; Hysterectomy, Vaginal ; Laparoscopy ; Thrombosis