Local warming at injection site helps alleviate pain after rocuronium administration

Mahajan, Charu; Rath, Girija Prasad; Bithal, Parmod K.; Prabhakar, Hemanshu; Yadav, Rahul; Dube, Surya Kumar

doi:10.1007/s00540-010-1014-2

Cited by 14 publications

(12 citation statements)

References 19 publications

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“…The present findings also are consistent with the findings of Park et al (2002), who demonstrated that local warming of intravenous injection site reduced propofol injection pain. In addition, the present findings are supported by the prior findings that local warming reduces rocuronium injection pain induced by higher acidity (Mahajan et al, 2010) and that the increased blood flow dilutes rocuronium concentration and reduces rocuronium injection pain (Blunk et al, 2003;Klement and Arnd, 1991).…”

Section: Page 17 Of 31supporting

confidence: 90%

“…Biophysical effects in heat therapy require a 3-4 o C increase in skin temperature (Kankaanpää et al, 1999) and local warming of arm at 42 o C vasodilatates the cutaneous arterior smooth muscle (Taylor et al, 1984). Local warming seems to reduce the incidence of rocuronium injection or propofol injection pain with no evident adverse effects (Mahajan et al, 2010;Park et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the effects of lidocaine pre-administration and local warming of the intravenous access site on propofol injection pain: Randomized, double-blind controlled trial

Jeong

Yoon

2016

International Journal of Nursing Studies

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Section: Page 17 Of 31supporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Comparison of the effects of lidocaine pre-administration and local warming of the intravenous access site on propofol injection pain: Randomized, double-blind controlled trial

Jeong

Yoon

2016

International Journal of Nursing Studies

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“…yöntemler de etkili bulunmuştur (5,6). Enjeksiyon ağrısını engellemek için kullanılan ajanların ven oklüzyonu tekniği ile uygulanması etkinliklerini artırmaktadır ve lidokain bu amaçla kullanılan ajanlar içinde en etkin bulunanlardandır.…”

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Prevention of Withdrawal Movement Associated with the Injection of Rocuronium in Children: Comparison of Paracetamol and Lidocaine

Polat¹,

Akın²,

Keskin³

et al. 2016

Turk J Anaesth Reanim

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Amaç: İntravenöz (i.v) roküronyum enjeksiyonu sonrası hastaların %50-80'i gibi büyük bir kısmında ağrı görülmektedir. Bu araştırma-nın amacı, genel anestezi altında ameliyat geçirecek çocuk hastalarda, i.v. roküronyum enjeksiyonuna bağlı çekme hareketini önlemede, ön-ceden uygulanan i.v. parasetamolün etkinliğini i.v. lidokain ile karşı-laştırmaktır.Yöntemler: Genel anestezi uygulanacak olan 90 hasta basit kura çek-me yöntemi ile rastgele iki gruba ayrıldı; parasetamol grubu (Grup P, n=45) ve lidokain grubu (Grup L, n=45). Anestezi indüksiyonunun ardından tansiyon manşonu 75 mm Hg'ya kadar şişirilerek ven oklüzyonu uygulandı ve Grup P'de i.v. 50 mg parasetamol, Grup L'de i.v. 0,5 mg kg -1 lidokain uygulandı. Ven oklüzyonu 60 saniye (sn) sonra açıldı 0,6 mg kg -1 roküronyum 5 sn'de enjekte edildi. Hastalarda gözlenen hareketler, 4 puanlık bir skala [0: hareket yok, 1: sadece bilekte hareket var, 2: sadece kolda hareket var (dirsek/omuz), 3: bir ekstremiteden daha yaygın hareket] ile değerlendirildi. Bulgular:Kol çekme hareketinin sıklığı parasetamol ve lidokain gruplarında sırasıyla %42 ve %26 olarak tespit edildi (p=0,120). Çekme hareketi görülmeyen ve hafif çekme hareketi görülen hasta sayıları bakımından gruplar arasında fark yokken, orta şiddette çekme hareketi görülen hasta sayısı Grup L ile karşılaştırıldığında, Grup P'de anlamlı olarak fazlaydı (p<0,05). Her iki grupta da hastaların hiçbirinde yaygın hareket görülmedi. Sonuç:Ven oklüzyonu tekniği kullanılarak uygulanan 50 mg parasetamol, roküronyum enjeksiyon ağrısına bağlı çekme hareketini çocuk hastaların %58'inde engeller, ancak orta şiddette çekme hareketini önlemede lidokain kadar etkili değildir. Anahtar kelimeler: Roküronyum, kol çekme hareketi, lidokain, parasetamolObjective: Pain from rocuronium injection is observed in 50%-80 % of patients. This study aimed to compare the effectiveness of pretreatment with paracetamol and lidocaine in preventing pain-induced withdrawal caused by the intravenous injection of rocuronium during the induction of general anaesthesia in paediatric patients.Methods: Ninety children were randomized into two groups using a simple drawing from the box method: a paracetamol group (Group P, n=45) and a lidocaine group (Group L, n=45). After anaesthesia induction, venous occlusion was applied by a paediatric cuff inflated to a pressure of 75 mmHg and by 50 mg paracetamol and 0.5 mg kg −1 lidocaine was injected in Groups P and L, respectively. Venous occlusion was then released, followed by rocuronium injection (0.6 mg kg −1 ). Withdrawal was evaluated using a 4-point scale (1, no response; 2, movement at the wrist only; 3, movement/ withdrawal involving arm only (elbow/shoulder) and 4, generalized response, movement/withdrawal in more than one extremity). Results:The incidence of withdrawal movement was 42% and 26% in the Groups P and L, respectively (p=0.120). Although no significant differences were noted in the number of patients who had no withdrawal movement and mild withdrawal movement in Groups P and L, compared with G...

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“…Rocuronium bromide can cause severe burning pain on hand and/or arm especially if intravenous catheters are displaced. In some cases, it may cause bronchospasm (2,5). The mechanism through which pain is generated is still unknown but it is generally accepted that this phenomenon is caused by activation of poly modal nociceptors that leads to the release of endogenous mediators such as kinin, histamine and bradikinin and these mediate the pain response (2,6,7).…”

Section: Introductionmentioning

confidence: 99%

“…The mechanism through which pain is generated is still unknown but it is generally accepted that this phenomenon is caused by activation of poly modal nociceptors that leads to the release of endogenous mediators such as kinin, histamine and bradikinin and these mediate the pain response (2,6,7). There are several agents (including the use of local anesthetic drugs, thiopental, opioids, ondansetrone, magnesium, ketamine, antihistamines and ketorolac) and methods (dilution of rocuronium solution, slow injection rate and local warming) for alleviating this discomfort (1,4,5,(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Three Different Applications on Rocuronium Injection Pain: A Double Blinded, Randomized Clinical Study

Arslan¹,

Me²,

Karakoç³

et al. 2015

West Indian Med J

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Background: Some agents such as rocuronium and propofol induce severe and noxious pain when administered intravenously during anesthesia induction. This causes to additional stress for the patient who is already stressful due to operation. The purpose of our study was to compare the effects of remifentanyl with two different administration methods and lidocaine on rocuronium injection pain. Methods: This prospective, double blind, randomized study is designed with 120 patients aged between 17 and 70 years old, American Society of Anesthesiologists (ASA) physical status I-II, undergoing different elective surgery types that require muscle relaxation. Patients were randomly distributed to 3 groups; Group 1 (remifentanyl-bandaged, n=40), Group 2 (lidocaine-bandaged, n=40) and Group 3 (remifentanyl non-bandaged, n=40). Mean arterial pressure and pulse rate were recorded before induction, 1 minute after induction and after intubation. An independent anesthetist blind to groups assessed and recorded Verbal Rating Scale. Results: There were no significant differences between groups regarding demographic variables. Cardiovascular hemodynamics regarding mean arterial pressure and pulse did not change significantly between groups before and after induction and after intubation. Pain scores were comparable between groups. Conclusion: Remifentanyl can be used either with venous occlusion or as intravenous bolus to prevent rocuronium induced pain with no significant difference and it is as effective as lidocaine.

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Local warming at injection site helps alleviate pain after rocuronium administration

Abstract: Application of warmth over the vascular access prior to rocuronium administration effectively reduces injection-related pain.

Cited by 14 publications

References 19 publications

Comparison of the effects of lidocaine pre-administration and local warming of the intravenous access site on propofol injection pain: Randomized, double-blind controlled trial

Comparison of the effects of lidocaine pre-administration and local warming of the intravenous access site on propofol injection pain: Randomized, double-blind controlled trial

Prevention of Withdrawal Movement Associated with the Injection of Rocuronium in Children: Comparison of Paracetamol and Lidocaine

The Effect of Three Different Applications on Rocuronium Injection Pain: A Double Blinded, Randomized Clinical Study

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