Erbabacan Emre, Köksal Güniz Meyancı, Tütüncü Çiğdem Ayşe, Ekici Birsel, Tunalı Yusuf, Kaya Güner, Calay Özden Öz, Altındaş Fatiş
Department of Anaesthesiology and Reanimation, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Department of Biostatistics, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2013 Oct;41(5):162-6. doi: 10.5152/TJAR.2013.35. Epub 2013 May 23.
We aimed to evaluate Visual-Analogue-Scale (VAS) scores, hand-withdrawal, rash and skin eruptions after injections of different concentrations of rocuronium in intubation doses in alert patients using the isolated-forearm technique.
Eighty ASA I-II patients were included in a randomized, controlled, single-blinded study. Two 20 G cannulas were inserted into the dorsum of the left and right hand in each patient. A tourniquet was applied to the left arm and inflated to 50 mm Hg above the patient's systolic blood pressure. Group 1 (n=20) received 2.5 mg mL(-1) rocuronium diluted with 0.9% NaCl, Group 2 (n=20) received 5 mg mL(-1) rocuronium diluted with 0.9% NaCl, Group 3 (n=20) received 10 mg mL(-1) rocuronium and 0.4 mg mL(-1) lidocaine mixture, and Group 4 (n=20) received 10 mg mL(-1) rocuronium via a cannula on the left hand, provided that a dose of 0.6 mg mL(-1) were given to all groups of patients. VAS0-VAS60 values, hand-withdrawal, rash and skin eruptions were assessed in patients who were administered rocuronium but not under the effects of hypnotic or neuromuscular agents. Hemodynamic values were recorded both before and after the administration of hypnotic-neuromuscular agents.
VAS0 values were significantly higher in Group 4 when compared to Groups 1, 2 and 3 (p=0.032). No significant difference was observed between VAS0 and VAS60 values in Groups 1, 2 and 3. In Group 4, VAS0 values were significantly higher than VAS60 values (p=0.003). No significant difference was observed between groups in terms of side effects and hemodynamic values.
In conclusion, we determined that using rocuronium diluted with 0.9% NaCl was more effective in preventing injection pain than using a rocuronium-lidocaine mixture.
我们旨在使用孤立前臂技术，评估清醒患者在给予插管剂量的不同浓度罗库溴铵注射后，视觉模拟评分（VAS）、手部退缩反应、皮疹及皮肤疹的情况。
80例美国麻醉医师协会（ASA）分级为I-II级的患者纳入一项随机、对照、单盲研究。每位患者在左手和右手背各插入两根20G套管针。对左臂应用止血带并充气至高于患者收缩压50mmHg。第1组（n = 20）接受用0.9%氯化钠稀释的2.5mg/mL罗库溴铵，第2组（n = 20）接受用0.9%氯化钠稀释的5mg/mL罗库溴铵，第3组（n = 20）接受10mg/mL罗库溴铵与0.4mg/mL利多卡因的混合物，第4组（n = 20）通过左手的套管针接受10mg/mL罗库溴铵，前提是所有组患者均给予0.6mg/mL的剂量。对接受罗库溴铵但未处于催眠或神经肌肉药物作用下的患者评估VAS0-VAS60值、手部退缩反应、皮疹及皮肤疹。在给予催眠-神经肌肉药物之前和之后记录血流动力学值。
与第1、2和3组相比，第4组的VAS0值显著更高（p = 0.032）。第1、2和3组的VAS0值与VAS60值之间未观察到显著差异。在第4组中，VAS0值显著高于VAS60值（p = 0.003）。在副作用和血流动力学值方面，各组之间未观察到显著差异。
总之，我们确定用0.9%氯化钠稀释的罗库溴铵在预防注射疼痛方面比使用罗库溴铵-利多卡因混合物更有效。
