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Neutralized rocuronium (pH 7.4) before administration prevents injection pain in awake patients: a randomized prospective trial

 Dong Woo Han  ;  Bon Nyeo Koo  ;  Ki Jun Kim  ;  Manohar Sharma  ;  Yang Sik Shin  ;  Jong Seok Lee  ;  Seung Ho Choi 
 JOURNAL OF CLINICAL ANESTHESIA, Vol.19(6) : 418-423, 2007 
Journal Title
Issue Date
Adult ; Androstanols/administration & dosage* ; Androstanols/adverse effects ; Humans ; Hydrogen-Ion Concentration ; Injections/adverse effects ; Middle Aged ; Neuromuscular Nondepolarizing Agents/administration & dosage* ; Pain/prevention & control* ; Prospective Studies ; Rocuronium ; Sodium Bicarbonate/administration & dosage* ; Time Factors ; Wakefulness
STUDY OBJECTIVE: To determine (1) the amount of 8.4% sodium bicarbonate (NaHCO(3)) to adjust the pH of rocuronium to 7.4 (neutralization), (2) to show whether neutralizing the pH of rocuronium can prevent pain, and (3) to confirm that rocuronium mixed with NaHCO(3) does not change the physical property and efficacy of rocuronium. DESIGN: Prospective studies. SETTING: University medical center. PATIENTS: 180 ASA physical status I and II women patients undergoing elective gynecologic surgery. INTERVENTIONS AND MEASUREMENTS: 60 patients were randomly allocated to group 1 (rocuronium only), group 2 (rocuronium 50 mg mixed with 0.9% NaCl 3 mL), and group 3 (rocuronium 50 mg mixed with 8.4% NaHCO(3) 3 mL). All patients received mixtures equal to 0.04 mg/kg of rocuronium and were asked to evaluate their pain with visual analog scale (VAS) and pain scores. In other settings, the onset time and duration of action of each group of rocuronium were measured. The dose of rocuronium required to produce a 50% twitch depression (ED(50)) was calculated. MAIN RESULTS: The amount of 8.4% NaHCO(3) needed to neutralize 50 mg of rocuronium was 3.1 +/- 0.3 mL. VAS scores were lower in group 3 than in groups 1 or 2 (P < 0.05). There were no differences in onset time, duration of action, or ED(50) values among the groups. CONCLUSIONS: Rocuronium neutralized with NaHCO(3) prevents intravenous injection pain. The physical and pharmacologic properties of rocuronium mixed with NaHCO(3) immediately before administration are not altered.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kim, Ki Jun(김기준) ORCID logo https://orcid.org/0000-0003-1950-7998
Shin, Yang Sik(신양식)
Lee, Jong Seok(이종석) ORCID logo https://orcid.org/0000-0002-7945-2530
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0001-8442-4406
Han, Dong Woo(한동우) ORCID logo https://orcid.org/0000-0002-8757-663X
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