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Remifentanil prevents withdrawal movements caused by intravenous injection of rocuronium

 Byung In Choi  ;  Seung Ho Choi  ;  Yang-Sik Shin  ;  Sung Jin Lee  ;  Kyung Bong Yoon  ;  Seo Kyung Shin  ;  Ki-Young Lee 
 YONSEI MEDICAL JOURNAL, Vol.49(2) : 211-216, 2008 
Journal Title
Issue Date
Adult ; Aged ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/therapeutic use ; Androstanols/administration & dosage ; Androstanols/adverse effects* ; Female ; Humans ; Injections, Intravenous/adverse effects ; Middle Aged ; Pain/etiology ; Pain/prevention & control* ; Piperidines/administration & dosage ; Piperidines/therapeutic use*
Remifentanil ; rocuronium ; withdrawal movements
PURPOSE: The incidence of pain induced withdrawal movement following intravenous injection of rocuronium is high. This randomized, double-blind, placebo-controlled study was designed to evaluate the effect of pretreatment of remifentanil on the withdrawal movements due to intravenous injection of rocuronium during anesthetic induction. MATERIALS AND METHODS: Ninety adult female patients undergoing thyroidectomy were randomly allocated to three groups. Each patient intravenously received one of three solutions of equal volume (4 mL): normal saline (Group I, n=30), 0.5 microg/kg remifentanil (Group II, n=30) or 1 microg/kg remifentanil (Group III, n=30). Thirty seconds after remifentanil administration, anesthesia was induced with 5 mg/kg IV thiopental. Twenty seconds after thiopental injection, 0.6 mg/kg IV rocuronium was administered (injection rate of 0.5 mL/sec) and patients' withdrawal movements were assessed. Mean arterial pressure (MAP) and heart rate were assessed on arrival in the operation room, before the tracheal intubation and immediately, 1 and 2 min after the tracheal intubation. RESULTS: The incidence of withdrawal movements was significantly lower in both of the remifentanil groups (3 and 0% in Group II and III, respectively) than in the saline group (70%). Remifentanil attenuated the increase of heart rate and MAP immediately and 1 min after the tracheal intubation. CONCLUSION: The pretreatment with 0.5 and 1.0 microg/kg remifentanil of bolus doses prevented the withdrawal movements caused by rocuronium injection, and effectively blunted cardiovascular activation following tracheal intubation
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Shin, Seokyung(신서경) ORCID logo https://orcid.org/0000-0002-2641-0070
Shin, Yang Sik(신양식)
Yoon, Kyoung Bong(윤경봉) ORCID logo https://orcid.org/0000-0002-4167-1375
Lee, Ki Young(이기영) ORCID logo https://orcid.org/0000-0003-4893-3195
Lee, Sung Jin(이성진)
Choi, Byung In(최병인)
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0001-8442-4406
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