rocuronium and Erythema

The purpose of this study was to investigate whether gender influences the perception of pain on injection of rocuronium.. In this prospective, placebo-controlled trial 120 patients were randomized into four groups to receive rocuronium 0.03 mg kg(-1) (40 female and 40 male patients) or saline (20 female and 20 male patients). The incidence and severity of the injection pain after administration of the study drug was compared between female and male patients using a numerical rating scale (0-10). Signs of local irritation, i.e. erythema and thrombophlebitis, were assessed up to 48 h after surgery.. In 26 (32.5%) of the 80 patients receiving rocuronium, pain on injection was observed. This occurred significantly more frequently in the female compared with male patients: 18 (45%) vs. eight (20%), respectively (P = 0.032). The severity was more pronounced in the women than in the men (P = 0.020). The incidence of the rocuronium-associated pain was significantly increased compared with the Saline groups (P < 0.001). After surgery no patient complained of any residual pain and no local signs were observed in any patient during the study period.. Women experienced more pain on injection of rocuronium than men, moreover this is an additional evidence for gender-related differences in pain perception. When rocuronium is used as a precurarization agent, an analgesic pretreatment (e.g. opioids) should be considered, especially for female patients.

Topics: Adolescent; Adult; Aged; Androstanols; Double-Blind Method; Erythema; Female; Humans; Male; Middle Aged; Neuromuscular Nondepolarizing Agents; Pain; Prospective Studies; Rocuronium; Sex Characteristics; Thrombophlebitis

We evaluated the pretreatment of small-dose of ketamine or normal saline in the reduction of withdrawal movements induced by rocuronium injection. One-hundred pediatric patients (aged 1-6 yr) were randomly assigned into 2 groups. A 22-gauge IV cannula was inserted into the dorsum of the hand, and ketamine 0.2 mg/kg or normal saline was given, followed by a 5 mg/kg thiopental injection 10 s later. IV rocuronium (0.8 mg/kg) was injected over 5 s. The patient's response to rocuronium injection was graded by using a four-point scale in a double-blinded manner. We observed that the incidence of withdrawal movements was 83% in the saline group and 27% in patients pretreated with ketamine (P < 0.05). Some patients in both groups developed skin erythema at the site of injection. We conclude that pretreatment with small-dose ketamine significantly attenuates withdrawal movements associated with IV injection of rocuronium in pediatric patients anesthetized with thiopental.. Pretreatment with small-dose ketamine 0.2 mg/kg provides a simple and safe means of reducing the incidence of withdrawal movements induced by the injection of rocuronium, a short-acting nondepolarizing muscle relaxant.

Topics: Androstanols; Anesthetics, Dissociative; Child; Child, Preschool; Double-Blind Method; Erythema; Female; Humans; Infant; Injections, Intravenous; Ketamine; Male; Movement; Neuromuscular Nondepolarizing Agents; Preanesthetic Medication; Rocuronium; Skin