The effect of palonosetron on rocuronium-induced withdrawal movement

Park, Ki-Bum; Jeon, Yunseok; Yi, Junggu; Kim, Jihyun; Chung, Sung Kwang; Kwak, Kyung Hwa

doi:10.1016/j.bjane.2016.04.002

Cited by 4 publications

(8 citation statements)

References 26 publications

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“…In this study, the overall incidence of rocuronium-induced withdrawal response was lower (27.8%) in the group that received a continuous infusion of remifentanil after nefopam pretreatment compared with those (38% to 45%) in groups that received serotonin receptor antagonists [5,6,8]. The incidence was reduced by approximately 30% more in the group that received a continuous infusion of remifentanil after nefopam pretreatment than that during remifentanil infusion alone (60.5%).…”

Section: Discussionmentioning

confidence: 56%

“…The overall incidences of rocuroniuminduced withdrawal response were 38% to 45% in palonosetron (0.075 mg), 44% in ondansetron (4 mg), and 87.5% to 75% in 0.9% isotonic saline groups [5,6,8]. The incidences of moderate to severe withdrawal response were 8% to 22.5% in palonosetron, 16% in ondansetron (4 mg), and 58% to 65% in 0.9% isotonic saline groups [5,6,8]. Unfortunately, we did not investigate the incidence of rocuronium-induced withdrawal response in patients who received nefopam pretreatment alone.…”

Section: Discussionmentioning

confidence: 99%

“…Studies of serotonin receptor antagonists reported that ondansetron and palonosetron were effective in the prevention of rocuronium-induced withdrawal response [5][6][7][8]. The overall incidences of rocuroniuminduced withdrawal response were 38% to 45% in palonosetron (0.075 mg), 44% in ondansetron (4 mg), and 87.5% to 75% in 0.9% isotonic saline groups [5,6,8]. The incidences of moderate to severe withdrawal response were 8% to 22.5% in palonosetron, 16% in ondansetron (4 mg), and 58% to 65% in 0.9% isotonic saline groups [5,6,8].…”

Section: Discussionmentioning

confidence: 99%

“…Many clinical studies have tried to reduce the withdrawal response by various pharmacological interventions [2][3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors suggested that non-opioid analgesics such as tramadol and paracetamol also effectively reduced rocuronium-induced withdrawal response, even though their effects were less than that of lidocaine [4,6]. In addition, serotonin receptor antagonists such as ondansetron and palonosetron were also effective in the prevention of rocuronium-induced withdrawal response, although there is some controversy regarding the effectiveness of serotonin receptor antagonists compared to that of lidocaine [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Combination of nefopam and remifentanil is more effective to reduce rocuronium-induced withdrawal response compared with remifentanil alone: a prospective, double-blinded, randomized control study

Jung

Kim

et al. 2018

Anesth Pain Med

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Rocuronium has generally been used in anesthetic practice by bolus injection for muscle relaxation during tracheal intubation or by continuous infusion [1]. However, rocuronium may induce a withdrawal response due to intense injection This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: We investigated the effect of combination of nefopam and remifentanil under the hypothesis that nefopam would effectively prevent rocuronium-induced withdrawal response by blocking serotonin receptors and providing a synergistic or additional effect with remifentanil.Methods: After receiving Institutional Review Board approval, 76 patients aged between 20 and 65 years with American Society of Anesthesiologists physical statuses of I or II were randomly allocated to the control group and nefopam group. In the control group, 102 ml of 0.9% sodium chloride solution was infused one hour before surgery at 100 ml/h. In the nefopam group, 20 mg nefopam (2 ml) in 100 ml of a 0.9% sodium chloride solution was infused one hour before surgery at 100 ml/h. Rocuronium (0.6 mg/kg) was injected after the induction of anesthesia with remifentanil and propofol at target concentrations of 2.0 ng/ml and 3.0 mg/ml, respectively. The grades of rocuronium-induced withdrawal response were evaluated using a four-point scale. The hemodynamics and respiratory rates were recorded upon operating room arrival, after anesthesia induction, and one minute post-injection of rocuronium.Results: Two patients (nefopam group) were excluded due to incomplete infusion and side effects; thus, 74 patients were finally analyzed. The overall incidence of rocuroniuminduced withdrawal response was significantly lower in nefopam group (27.8%, n = 36) than in control group (60.5%, n = 38) (P = 0.005). Conclusions:The combination of nefopam (20 mg) and remifentanil is more effective at reducing rocuronium-induced withdrawal response than remifentanil infusion alone with stable hemodynamics.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Many clinical studies have tried to reduce the withdrawal response by various pharmacological interventions [2][3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combination of nefopam and remifentanil is more effective to reduce rocuronium-induced withdrawal response compared with remifentanil alone: a prospective, double-blinded, randomized control study

Jung

Kim

et al. 2018

Anesth Pain Med

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The Effect of 5-Hydroxytryptamine Receptor Antagonist in Preventing Pain/Limb Shrinkage Reaction Associated with Rocuronium Injection

Zhou

Zhu

2018

BioMed Research International

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Objectives To evaluate the effect and safety of 5-hydroxytryptamine (5-HT) receptor antagonist in alleviating the pain of patients under general anesthesia induced by rocuronium injection and preemptive analgesia. Methods Meta-analysis was conducted with RevMan 5.1 software by electronically retrieving the databases of PubMed, Embase, the Cochrane Library, WanFang Data, and CNKI and collecting the published random control tests (RCTs) where 5-hydroxytryptamine receptor antagonist was used to alleviate the pain/limb shrinkage reaction associated with rocuronium injection. Results Seven RTCs, including 556 patients, were included. The results of meta-analysis showed the following. (1) Compared to the control group, 5-HT receptor antagonist could prevent the total pain/limb shrinkage reaction associated with rocuronium injection [RR=0.62, 95% CI (0.54, 0.71), P<0.00001] and reduce the incidence rate of mild and moderate pain/limb shrinkage reaction associated with rocuronium injection [RR=0.46, 95% CI (0.33, 0.63), P<0.00001; RR=0.18, 95% CI (0.11, 0.31), P<0.000 01]. (2) Compared to the lidocaine group, the incidence rate was higher in preventing the pain/limb shrinkage reaction associated with rocuronium injection by 5-HT receptor antagonist, which was statistically significant [RR=1.33, 95% CI (1.05, 1.68), P=0.02]. Conclusion 5-hydroxytryptamine receptor antagonist may be effective in preventing the pain/limb shrinkage reaction associated with rocuronium injection.

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The effect of orally administered metoprolol on the frequency and severity of rocuronium injection pain

ŞEN,

KALAYCI,

KABAOSMAN

et al. 2023

The European Research Journal

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Objectives: This study aimed to examine the effects of orally administered metoprolol on the frequency and severity of pain caused by rocuronium injection in patients who started to use and were currently using oral metoprolol for any reason such as ischemic heart disease, hypertension, and arrhythmias. Methods: Patients were evaluated in four groups. Group M: patients currently using metoprolol and who did not receive lidocaine before the application of rocuronium. Group ML: patients currently using metoprolol and who received lidocaine before rocuronium application. Group L: patients currently not using metoprolol and received lidocaine before rocuronium application. Group C: patients currently not using metoprolol and who did not receive lidocaine before rocuronium application. Following the induction of general anesthesia with thiopental sodium, a researcher blind to the groups observed the pain during rocuronium injection based on the following scale: (1) no reaction, (2) movement only in the ankle, (3) movement or withdrawal only in the arm (shoulder and ankle), and (4) diffuse reaction (movement or withdrawal in more than one extremity, coughing and holding breath). Results: Two hundred patients with 50 in each of four groups were included. The incidence of pain was statistically significantly lower in Group ML compared to Groups M and C (p = 0.001). The correlations between pain caused by rocuronium injection and duration of metoprolol usage and the time since the last dose were not statistically significant (for all, p > 0.05). Conclusions: Oral metoprolol combined with lidocaine reduced pain and withdrawal reflex caused by rocuronium injection. No significant difference was observed between the last dose and the duration of metoprolol usage.

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The effect of palonosetron on rocuronium-induced withdrawal movement

Cited by 4 publications

References 26 publications

Combination of nefopam and remifentanil is more effective to reduce rocuronium-induced withdrawal response compared with remifentanil alone: a prospective, double-blinded, randomized control study

Combination of nefopam and remifentanil is more effective to reduce rocuronium-induced withdrawal response compared with remifentanil alone: a prospective, double-blinded, randomized control study

The Effect of 5-Hydroxytryptamine Receptor Antagonist in Preventing Pain/Limb Shrinkage Reaction Associated with Rocuronium Injection

The effect of orally administered metoprolol on the frequency and severity of rocuronium injection pain

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