Hemodynamic Responses of Pretreatments Designed to Reduce Withdrawal Movements Following Rocuronium Injection: A Comparison of Alfentanil with Lidocaine.

Park,  Sun Eun; Park,  Se Hun; Cho,  Young Woo; Son,  Hee Won; Lee,  Ji Ho; Kim,  Dae Young

doi:2008.54.5.507

Original Article

Korean Journal of Anesthesiology 2008;54(5):507-512.
DOI: https://doi.org/10.4097/kjae.2008.54.5.507

Hemodynamic Responses of Pretreatments Designed to Reduce Withdrawal Movements Following Rocuronium Injection: A Comparison of Alfentanil with Lidocaine.

Sun Eun Park, Se Hun Park, Young Woo Cho, Hee Won Son, Ji Ho Lee, Dae Young Kim

¹Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea. ywcho67@ulsan.ac.kr
²Department of Occupational and Environmental Medicine, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea.

Abstract

BACKGROUND
This study was conducted to compare the efficacy of intravenous alfentanil and lidocaine as a pretreatment for the prevention of withdrawal movements following a rocuronium injection and hemodynamic change following tracheal intubation.
METHODS
This study evaluated 180 patients that were divided into the following 3 pretreatment groups: group C: normal saline, group L: lidocaine 1 mg/kg, group A: alfentanil 10microgram/kg. Anesthesia was induced using 5 mg/kg thiopental sodium, after which the test drug was injected. Rocuronium (1 mg/kg) was then administered 1 minute after the test drug was injected over 5 seconds and the response was characterized as one of the following: no movement, movement limited to the wrist, to the elbow or to the shoulder. Intubation was performed 1 minute later. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were then recorded at each of the following points: T1: preinduction, T2: immediately prior to rocuronium injection, T3: immediately after rocuronium injection, T4: immediately prior to intubation, T5: immediately after intubation, T6: 1 minute after intubation, T7: 5 minutes after intubation.
RESULTS
The incidence of withdrawal movement was significantly lower in group A than groups C and L (P < 0.05). In addition, SBP, DBP and HR following intubation were significantly lower in group A than group C and group L (P < 0.05).
CONCLUSIONS
Pretreatment with 10microgram/kg of alfentanil effectively reduced the incidence of withdrawal movement in response of rocuronium injection and caused minimal hemodynamic changes following intubation.

Key Words: alfentanil; hemodynamic change; lidocaine; rocuronium; withdrawal movement