| Comparison of Premixed NaHCO3 and Lidocaine on Rocuronium Injection Pain. |
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Sung Mee Jung, Na Young Ko, Young Su Lim, Po Soon Kang, Hee Uk Kwon |
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Department of Anesthesiology and Pain Medicine, School of Medicine, Konyang University, Daejeon, Korea. applejsm@hotmail.com |
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| 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. |
| Key Words:
lidocaine; pain; rocuronium; sodium bicarbonate; withdrawal movement |
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