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Pretreatment with remifentanil to prevent withdrawal after rocuronium in children.

Kim, JY; Kim, YB; Kwak, HJ
British journal of anaesthesia, 98(1):120-123, 2007
Journal Title
British journal of anaesthesia
BACKGROUND: Pain from rocuronium injection is a common side-effect reported to occur in 50-80% of the patients. This randomized, double-blind, placebo-controlled study was designed to evaluate the efficacy of pretreatment with i.v. remifentanil on prevention of withdrawal response during rocuronium injection in paediatric patients.

METHODS: After obtaining parental consents, 70 paediatric patients were randomly allocated into two groups to receive either i.v. remifentanil 1 mug kg(-1) (remifentanil group, n=35) or i.v. saline 5 ml (saline group, n=35). Anaesthesia was induced with thiopental sodium 2.5% (5 mg kg(-1)) and the test drug was injected over 30 s. One minute after the test drug injection, rocuronium 1% (0.6 mg kg(-1)) was injected over 5 s and the response was recorded. Mean arterial pressure (MAP) and heart rate were recorded on arrival in the operating theatre, before and 1 min after the tracheal intubation.

RESULTS: The overall incidence of withdrawal movements was significantly higher in the saline group (33 patients; 94%) than that in the remifentanil group (8 patients; 23%) (P<0.001). No patient in the remifentanil group showed generalized movement, whereas 51% of patients in the saline group did. Remifentanil prevented significant increase in MAP after intubation.

CONCLUSION: This study demonstrated that pretreatment with remifentanil 1 microg kg(-1) provided a safe and simple method for reducing the incidence of rocuronium-associated withdrawal movement with haemodynamic stability in children.
MeSH terms
Analgesics, Opioid/therapeutic use*Androstanols/administration & dosage*Blood Pressure/drug effectsChildChild, PreschoolDouble-Blind MethodFemaleHeart Rate/drug effectsHumansInjections, Intravenous/adverse effectsMaleMovement/drug effectsNeuromuscular Nondepolarizing Agents/administration & dosage*Pain/etiologyPain/prevention & control*Piperidines/therapeutic use*Prospective Studies
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Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
AJOU Authors
김, 종엽
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