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Combination of nitrous oxide and lidocaine to prevent withdrawal after rocuronium in children

Authors
Kwak, HJ; Chae, YJ; Lee, SY; Kim, YJ; Kim, JY
Citation
Korean journal of anesthesiology, 58(5):446-449, 2010
Journal Title
Korean journal of anesthesiology
ISSN
2005-64192005-7563
Abstract
Background



Pain at the site of rocuronium injection is a common side-effect in pediatric patients. This prospective, randomized, double-blind study evaluated the efficacy of a combination of nitrous oxide and lidocaine pretreatment on withdrawal response during rocuronium injection in children.



Methods



Sixty six pediatric patients, ages 5 to 12 years, were randomly assigned to two groups. The oxygen group received 100% oxygen, and the nitrous oxide group received 50% N2O in oxygen over 2 min. After anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and manual occlusion of the forearm was performed, 1% lidocaine 1 mg/kg was injected over 15 sec. After the occlusion was released, 0.1% rocuronium 0.6 mg/kg was injected over 5 sec. Patient response to rocuronium injection was graded using a 4-point scale.



Results



Overall incidence of withdrawal movements was significantly lower in the nitrous oxide group (1 patients; 3.1%) than in the oxygen group (8 patients; 25.8%) (P = 0.013). No patient in the nitrous oxide group displayed arm or generalized movement (grade 3 or 4) associated with rocuronium injection.



Conclusions



This study demonstrated that a combination of inhaled 50% N2O in O2 and 1 mg/kg lidocaine pretreatment significantly reduced the incidence of rocuronium-induced withdrawal movements in pediatric patients compared with lidocaine pretreatment alone.
Keywords
LidocaineNitrous oxideRocuroniumWithdrawal
DOI
10.4097/kjae.2010.58.5.446
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
AJOU Authors
채, 윤정이, 숙영김, 종엽
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