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

Abstract

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.

Prevention of withdrawal associated with the injection of rocuronium in adults and children

“…In pediatric patients, the withdrawal incidence of 83% to 84% was reported after rocuronium, and the incidence of generalized movement was reported in 48% to 49% of patients [1,9]. We had similar results (80% and 50% of patients, respectively).…”

“…doi:10.1016/j.jclinane.2005. 12.001 have been used to try to reduce this withdrawal movement and pain: pretreatment with ondansetron [6,7], lidocaine [1,[6][7][8], tramadol [6], fentanyl [2,6], and ketamine [9]. Unfortunately, the failure rate is between 7% and 35% after the pretreatment in adult [6][7][8] and higher incidence (27%-46%) in children [1,9].…”

Local warming at injection site helps alleviate pain after rocuronium administration

“…As it holds a unique place among the nondepolarizing relaxants, continual efforts have been made to alleviate this painful side effect and various strategies have been proposed. Pretreatment or mixing with a variety of drugs such as thiopental, ondansetron, lidocaine, fentanyl, alfentanil, tramadol esmolol, magnesium sulphate, ketamine, antihistaminics, and sodium bicarbonate has been used in an attempt to reduce this pain [7][8][9][10][11][12][13]. The analgesic action of heat is mediated by the gate-control theory of pain [14].…”

The effect of Rocuronium Administration Rate And Remifentanil on The Prevention of Rocuronium Injection Pain in Pediatric Cases

“…Bu amaçla lidokain, esmolol, ketamin, opioidler, deksmedotimidin, asetaminofen, nötralize edilmiş rokuronyum, dilüsyon metodu gibi tedavi modaliteleri denenmiştir. [2,[23][24][25][26] Bu çalışma bazı limitasyonlar içermektedir. Bunlar arasında uygulanan roküronyum dilüe edilmeden ve infüzyon pompası kullanılmadan IV verilmiştir.…”