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Anesth Analg 2004;99:740-743
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000130005.94395.B2

ANESTHETIC PHARMACOLOGY

Dilution of Rocuronium to 0.5 mg/mL with 0.9% NaCl Eliminates the Pain During Intravenous Injection in Awake Patients

Bahattin Tuncali, MD, Ayse Karci, MD, Binnur Erdalkiran Tuncali, MD, Omur Mavioglu, MD, Cimen Gulben Olguner, MD, Selin Ayhan, MD, and Zahide Elar, MD

Department of Anesthesiology and Reanimation, Dokuz Eylul University, Izmir, Turkey

Address correspondence and reprint requests to Bahattin Tuncali, MD, Huzur mah, Sumbul sok, No. 42/11 Narlidere, Izmir, Turkey. Address e-mail to bahattin.tuncali{at}deu.edu.tr

In a randomized, double-blinded, controlled study, we evaluated the effect of diluting rocuronium 10 mg/mL to 1 or 0.5 mg/mL with 0.9% NaCl on the pain associated with IV administration of rocuronium with small doses given before succinylcholine or nondepolarizing agent administration. One hundred fifty patients undergoing surgical procedures that required general anesthesia were randomized into three groups. Group 1 received rocuronium 10 mg/mL. Groups 2 and 3 received 1 and 0.5 mg/mL of rocuronium, respectively. Patient demographics, pain scores, osmolality, and the pH of the solutions were recorded. Group 1 had the most intense and frequent pain response. Eighty percent of patients in this group reported pain on injection. In Group 2, the incidence and intensity of pain were significantly less when compared with those of Group 1. In this group, 38% of patients reported pain during injection. In Group 3, none of the patients experienced pain on injection. The pH values and osmolalities of study solutions were not significantly different among groups. In conclusion, in awake patients, dilution of rocuronium 10 mg/mL at small doses given before succinylcholine or nondepolarizing agent administration of 0.06 mg/kg to 0.5 mg/mL with 0.9% NaCl is a simple and cost-effective strategy for preventing pain during IV rocuronium injection.

IMPLICATIONS: In awake patients, pain on injection of rocuronium during the induction of general anesthesia is common. The osmolality and pH of the solutions were the same in all groups. Dilution of rocuronium to 1 and 0.5 mg/mL with 0.9 % NaCl decreased or prevented the pain during IV injection.




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J. Y. Kim, J. Y. Kim, Y. B. Kim, and H. J. Kwak
Pretreatment with remifentanil to prevent withdrawal after rocuronium in children
Br. J. Anaesth., January 1, 2007; 98(1): 120 - 123.
[Abstract] [Full Text] [PDF]


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 © 2004 by the International Anesthesia Research Society.