Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
2763891 | Journal of Clinical Anesthesia | 2007 | 5 Pages |
ObjectiveTo determine the effect of esmolol on the frequency and severity of pain and withdrawal reactions after injection of rocuronium and to compare it with lidocaine and placebo.DesignProspective, randomized, double-blind, placebo-controlled study.SettingSingle university hospital.Patients120 ASA physical status I and II patients undergoing general anesthesia for elective surgery.InterventionsPatients were randomized to receive esmolol (0.5 mg/kg), lidocaine (0.5 mg/kg), or placebo, followed by a subparalyzing dose of rocuronium. After induction of anesthesia with propofol and fentanyl, an intubating dose of rocuronium 0.6 mg/kg was given.MeasurementsPatients were observed after injection of rocuronium 0.05 mg/kg, then immediately asked if they had pain in the arm. The response was assessed; discomfort, pain, and withdrawal of the hand were recorded and graded using a 4-point scale (none, mild, moderate, or severe). After the intubating dose of rocuronium, withdrawal reactions were scored as follows: (a) no pain response, (b) pain limited to the wrist, (c) pain limited to the elbow/shoulder, or (d) generalized pain response.Results31 patients (77.5%) in the esmolol group, 32 (80%) in the lidocaine group, and 15 (37.5%) in the placebo group reported no pain (both groups vs placebo, P < 0.001). Moderate pain was seen in only one patient receiving lidocaine, in 6 placebo patients, but in none in the esmolol group (esmolol vs placebo, P < 0.05). Severe pain was felt by 8 patients receiving placebo, but by none receiving esmolol or lidocaine (P < 0.01). Frequency of withdrawal response after rocuronium was 2.5%, 17.5%, and 40% in the esmolol, lidocaine, and placebo groups, respectively (esmolol group vs placebo, P < 0.001; lidocaine group vs placebo, P < 0.05).ConclusionEsmolol, like lidocaine, reduces the frequency of pain and withdrawal reaction associated with rocuronium injection.