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Anesth Analg 2003;97:1294-1297
© 2003 International Anesthesia Research Society

PEDIATRIC ANESTHESIA

Pretreatment with Small-Dose Ketamine Reduces Withdrawal Movements Associated with Injection of Rocuronium in Pediatric Patients

Jiin-Tarng Liou, MD, Jee-Ching Hsu, MD, Fu-Chao Liu, MD, Daniel Ching-Wah Sum, MD, and Ping-Wing Lui, MD PhD

Department of Anesthesiology, Chang Gung Memorial Hospital, and Chang Gung University, Taoyuan, Taiwan

Address correspondence and reprint requests to Ping-Wing Lui, MD, PhD, Department of Anesthesiology, Chang Gung Memorial Hospital, 5 Fu-Shin St., Kweishan, Taoyuan, Taiwan 333. Address e-mail to pwlui{at}adm.cgmh.org.tw

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.

IMPLICATIONS: 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.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2003 by the International Anesthesia Research Society.