Effects of pretreatment with esmolol and lidocaine on injection pain androcuronium-induced withdrawal response

Background/aim: We aimed to compare the effectiveness of esmolol 1 mg/kg and lidocaine 1 mg/kg for injection pain and for the prevention of rocuronium-induced withdrawal response. Materials and methods: We enrolled a total of 81 patients in the study. Patients were randomly assigned to receive either 10 mL of 0.9% NaCl (Group P), esmolol 1 mg/kg (Group E), or lidocaine 1.0 mg/kg (Group L). A subparalyzing dose of rocuronium 0.05 mg/kg was administered to all patients and its effects were recorded. Anesthesia was induced with intravenous propofol and intravenous rocuronium 0.5 mg/kg in all groups. The withdrawal movements of the patient groups were subsequently graded. Results: There was a statistically significant difference in overall incidence of pain in group E and L compared to the placebo group after administrating the subparalyzed dose (no pain response: Group E = 81.5%, Group L = 77.8%, Group P = 14.8%) (P < 0.001). After intravenous administration of an intubating dose of rocuronium, the esmolol group had a significantly lower incidence of withdrawal movement than the other groups (no response: Group E = 81.5%, Group L = 63%, Group P = 22.2%) (P < 0.001). Conclusion: We found that esmolol significantly attenuates rocuronium-induced withdrawal movement and also reduces pain when used at subparalyzing doses.

Effects of pretreatment with esmolol and lidocaine on injection pain androcuronium-induced withdrawal response

Background/aim: We aimed to compare the effectiveness of esmolol 1 mg/kg and lidocaine 1 mg/kg for injection pain and for the prevention of rocuronium-induced withdrawal response. Materials and methods: We enrolled a total of 81 patients in the study. Patients were randomly assigned to receive either 10 mL of 0.9% NaCl (Group P), esmolol 1 mg/kg (Group E), or lidocaine 1.0 mg/kg (Group L). A subparalyzing dose of rocuronium 0.05 mg/kg was administered to all patients and its effects were recorded. Anesthesia was induced with intravenous propofol and intravenous rocuronium 0.5 mg/kg in all groups. The withdrawal movements of the patient groups were subsequently graded. Results: There was a statistically significant difference in overall incidence of pain in group E and L compared to the placebo group after administrating the subparalyzed dose (no pain response: Group E = 81.5%, Group L = 77.8%, Group P = 14.8%) (P < 0.001). After intravenous administration of an intubating dose of rocuronium, the esmolol group had a significantly lower incidence of withdrawal movement than the other groups (no response: Group E = 81.5%, Group L = 63%, Group P = 22.2%) (P < 0.001). Conclusion: We found that esmolol significantly attenuates rocuronium-induced withdrawal movement and also reduces pain when used at subparalyzing doses.

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  • Kwak HJ, Kim JY, Kim YB, Min SK, Moon BK, Kim JY. Pharmacological prevention of rocuronium-induced injection pain or withdrawal movements: a meta-analysis. J Anesth 2013; 27: 742–749.
  • Jeon Y, Baek SU, Park SS, Kim SO, Baek WY, Yeo JS. Effect of pretreatment with acetaminophen on withdrawal movements associated with injection of rocuronium: a prospective, randomized, double-blind, placebo controlled study. Korean J Anesthesiol 2010; 59: 13–16.
  • McCarthy GC, Megalla SA, Habib AS. Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. Drugs 2010; 70: 1149–1163.
  • Chia YY, Chan MH, Ko NH, Liu K. Role of β-blockade in anaesthesia and postoperative pain management after hysterectomy. Brit J Anaesth 2004; 93: 799–805.
  • Zhang Y, Xiang Y, Liu J. Prevention of pain on injection of rocuronium: a comparison of lidocaine with different doses of parecoxib. J Clin Anesth 2012; 24: 456–459.
  • Choi BI, Choi SH, Shin YS, Lee SJ, Yoon KB, Shin SK, Lee KY. Remifentanil prevents withdrawal movements caused by intravenous injection of rocuronium. Yonsei Med J 2008; 49: 211–216.
  • Lee HJ, Han SJ, Kim H, Lee IO, Kong MH, Kim NS, Lim SH, Lee MK. Antihistamine pretreatment to reduce incidence of withdrawal movement after rocuronium injection. J Korean Med Sci 2009; 24: 879–882.
  • Mencke T, Schreiber JU, Knoll H, Stracke C, Kleinschmidt S, Rensing H, Silomon M. Women report more pain on injection of a precurarization dose of rocuronium: a randomized, prospective, placebo-controlled trial. Acta Anaesth Scand 2004; 48: 1245–1248.
  • Liou JT, Hsu JC, Liu FC, Ching-Wah Sum D, Lui PW. Pretreatment with small-dose ketamine reduces withdrawal movements associated with injection of rocuronium in pediatric patients. Anesth Analg 2003; 97: 1294–1297.
  • Akcaboy ZN, Akcaboy EY, Soyal OB, Turhan G, Gogus N. Can ephedrine pretreatment be effective in alleviating rocuronium injection pain? Med Princ Pract 2012; 21: 323–327.
  • Turan A, Memis D, Karamanlioglu B, Sut N, Pamukcu Z. The prevention of pain from injection of rocuronium by magnesium sulphate, lignocaine, sodium bicarbonate and alfentanil. Anaesth Intens Care 2003; 31: 277–281.
  • Polat R, Aktay M, Ozlü O. The effects of remifentanil, lidocaine, metoclopramide, or ketamine pretreatment on propofol injection pain. Middle East J Anesthesiol 2012; 21: 673–677.
  • Huang YW, Buerkle H, Lee TH, Lu CY, Lin CR, Lin SH, Chou AK, Muhammad R, Yang LC. Effect of pretreatment with ketorolac on propofol injection pain. Acta Anaesth Scand 2002; 46: 1021–1024.
  • Cheong KF, Wong WH. Pain on injection of rocuronium: influence of two doses of lidocaine pretreatment. Brit J Anaesth 2000; 84: 106–107.
  • Akgün Salman E, Titiz L, Akpek E, Arslan G. Pretreatment with a very low dose of intravenous esmolol reduces propofol injection pain. Ağrı 2013; 25: 13–18.
  • Booze RM, Crisostomo EA, Davis JN. Beta-adrenergic receptors in the hippocampal and retrohippocampal regions of rats and guinea pigs: autoradiographic and immunohistochemical studies. Synapse 1993; 13: 206–214.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Esophageal replacement by hydroxylated bacterial cellulose patch in a rabbit model

Changlai ZHU, Fang LIU, Wenbo QIAN, Yingjie WANG, Qingsheng YOU, Tianyi ZHANG, Feng LI

Prevalence of hypertension and its association with obesity among schoolchildren aged 6-15 living in Sakarya Province in Turkey

Fatih Muhammed ÖNSÜZ, Figen DEMİR

Investigation of the effect of changes in muscle strength in gestational ageupon fear of falling and quality of life

Emrah ATAY, Fatma Başalan İZ

Evaluation of patency following revision technique ofhigh-velocity arteriovenous fistula

Ümit HALICI, Mehmet Ali KAYGIN, Özgür DAĞ, Ahmet AYDIN, Hüsnü Kamil LİMANDAL, Ümit ARSLAN, Eyüp Serhat ÇALIK, Bilgehan ERKUT

Asymmetric dimethylarginine is not a good predictor of ischemiausing myocardial perfusion scintigraphy

MELİH ENGİN ERKAN, MUHAMMET AŞIK, Taner UÇGUN, Nilgün YILDIZ, AYŞE YILMAZ, Yusuf ASLANTAŞ, Serkan BULUR, HURİ TİLLA İLÇE, Mustafa YILDIRIM, Ramazan MEMİŞOĞULLARI, AHMET SEMİH DOĞAN

The effects of aspirin, flurbiprofen, and NO-donating acetylsalicylic acid(NCX 4016) on mice models of endotoxic and septic shock

Nadir ULU, Alper Bektaş İSKİT, Cenk SÖKMENSÜER, Mustafa Oğuz GÜÇ

A study of the effect of Bacillus thuringiensis serotype H14 (subspecies israelensis)delta endotoxin on Musca larva

Mohammad Reza MEHRABI, Laya ZOGHIMOFRAD, Mahboubeh MAZINANI, Azim AKBARZADEH, Amirabbas RAHIMI

Is there a role of interstitial cells of Cajal and mast cells and eosinophilsin appendicitis in children?

Esra KARAKUŞ, Müjdem Nur AZILI, Bilge KARABULUT, Gülşah Bayram KABAÇAM, Resul KARAKUŞ

The risk of tumor cell dissemination in mediastinoscopy: a cytological study

YASEMİN BİLGİN BÜYÜKKARABACAK, AYŞEN TASLAK ŞENGÜL, BİLGE CAN MEYDAN, BURÇİN ÇELİK, MEHMET GÖKHAN PİRZİRENLİ, SELÇUK GÜRZ, ZEYNEP PELİN SÜRÜCÜ, AHMET BAŞOĞLU

Prevalence of hypertension and its association with obesity among school children aged 6 15 living in Sakarya Province in Turkey

Figen DEMİR, Fatih Muhammed ÖNSÜZ