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

Background
Some agents such as rocuronium and propofol induce severe and noxious pain when administered intravenously during anaesthesia induction. This causes additional stress for the patient 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 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 three 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, one minute after induction and intubation. An independent anaesthetist blind to groups assessed and recorded verbal rating scale.


Results
There were no significant differences between groups regarding demographic variables. Cardiovascular haemodynamics 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.