Effect of Sodium Bicarbonate or Lidocaine Mixed with Rocuronium on Withdrawal Movement during Rocuronium Injection. |
Sung Mi Hwang, Moon Seob Oh, So Young Lim |
Department of Anesthesiology, College of Medicine, Hallym University, Chuncheon, Korea. |
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Abstract |
BACKGROUND We have often observed arm withdrawal on administering rocuronium. This study was performed to determine the cause and to prevent this movement by mixing rocuronium with lidocaine or sodium bicarbonate. METHODS Sixty-two patients, ASA I-II, were randomized into three groups for this blind, prospective study. After induction of anesthesia by thiopental sodium 0.5 mg/kg, each group received rocuronium 0.6 mg/kg alone (group R), with 2% (2 ml) lidocaine (group L), or rocuronium with an equivalent volume of 8.4% sodium bicarbonate (group S). Patients' responses to the injection were graded using a 4-point scale and the pHs of the mixtures were measured. RESULTS The incidence rate of arm withdrawal was more reduced in groups L (47%) and S (45%) than in group R (80%) (P < 0.05). Severe withdrawal movement (grade 3) did not occur in group S (0%). CONCLUSIONS The incidence and the degree of withdrawal movement in response to the injection of rocuronium were significantly reduced by mixing an equivalent volume of 8.4% sodium bicarbonate with rocuronium. |
Key Words:
lidocaine; pain; rocuronium; sodium bicarbonate; withdrawal movement |
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