Korean J Anesthesiol.  2008 May;54(5):507-512. 10.4097/kjae.2008.54.5.507.

Hemodynamic Responses of Pretreatments Designed to Reduce Withdrawal Movements Following Rocuronium Injection: A Comparison of Alfentanil with Lidocaine

• Park SE
• Park SH
• Cho YW
• Son HW
• Lee JH
• Kim DY

• KMID: 2236545
• DOI: http://doi.org/10.4097/kjae.2008.54.5.507

Abstract

BACKGROUND: This study was conducted to compare the efficacy of intravenous alfentanil and lidocaine as a pretreatment for the prevention of withdrawal movements following a rocuronium injection and hemodynamic change following tracheal intubation.
METHODS
This study evaluated 180 patients that were divided into the following 3 pretreatment groups: group C: normal saline, group L: lidocaine 1 mg/kg, group A: alfentanil 10microgram/kg. Anesthesia was induced using 5 mg/kg thiopental sodium, after which the test drug was injected. Rocuronium (1 mg/kg) was then administered 1 minute after the test drug was injected over 5 seconds and the response was characterized as one of the following: no movement, movement limited to the wrist, to the elbow or to the shoulder. Intubation was performed 1 minute later. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were then recorded at each of the following points: T1: preinduction, T2: immediately prior to rocuronium injection, T3: immediately after rocuronium injection, T4: immediately prior to intubation, T5: immediately after intubation, T6: 1 minute after intubation, T7: 5 minutes after intubation.
RESULTS
The incidence of withdrawal movement was significantly lower in group A than groups C and L (P < 0.05). In addition, SBP, DBP and HR following intubation were significantly lower in group A than group C and group L (P < 0.05).
CONCLUSIONS
Pretreatment with 10microgram/kg of alfentanil effectively reduced the incidence of withdrawal movement in response of rocuronium injection and caused minimal hemodynamic changes following intubation.

Keyword

alfentanil; hemodynamic change; lidocaine; rocuronium; withdrawal movement

MeSH Terms

Alfentanil
Androstanols
Anesthesia
Blood Pressure
Elbow
Heart Rate
Hemodynamics
Humans
Incidence
Intubation
Lidocaine
Shoulder
Thiopental
Wrist
Alfentanil
Androstanols
Lidocaine
Thiopental