Korean J Anesthesiol.  2004 Feb;46(2):160-163. 10.4097/kjae.2004.46.2.160.

Effect of Sodium Bicarbonate or Lidocaine Mixed with Rocuronium on Withdrawal Movement during Rocuronium Injection

• Hwang SM
• Oh MS
• Lim SY

• KMID: 2039714
• DOI: http://doi.org/10.4097/kjae.2004.46.2.160

Abstract

BACKGROUND
We have often observed arm withdrawal on administering rocuronium. This study was performed to determine the cause and to prevent this movement by mixing rocuronium with lidocaine or sodium bicarbonate.
METHODS
Sixty-two patients, ASA I-II, were randomized into three groups for this blind, prospective study. After induction of anesthesia by thiopental sodium 0.5 mg/kg, each group received rocuronium 0.6 mg/kg alone (group R), with 2% (2 ml) lidocaine (group L), or rocuronium with an equivalent volume of 8.4% sodium bicarbonate (group S). Patients' responses to the injection were graded using a 4-point scale and the pHs of the mixtures were measured.
RESULTS
The incidence rate of arm withdrawal was more reduced in groups L (47%) and S (45%) than in group R (80%) (P < 0.05). Severe withdrawal movement (grade 3) did not occur in group S (0%).
CONCLUSIONS
The incidence and the degree of withdrawal movement in response to the injection of rocuronium were significantly reduced by mixing an equivalent volume of 8.4% sodium bicarbonate with rocuronium.

Keyword

lidocaine; pain; rocuronium; sodium bicarbonate; withdrawal movement

MeSH Terms

Anesthesia
Arm
Humans
Hydrogen-Ion Concentration
Incidence
Lidocaine*
Prospective Studies
Sodium Bicarbonate*
Sodium*
Thiopental
Lidocaine
Sodium
Sodium Bicarbonate
Thiopental