Polat Reyhan, Akın Mine, Keskin Gülsen, Ünal Dilek, Dönmez Aslı
Clinic of Anaesthesiology and Reanimation, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Clinic of Anaesthesia, Ankara Pediatrics Haematology Oncology Training and Research Hospital, Ankara, Turkey.
Turk J Anaesthesiol Reanim. 2016 Apr;44(2):86-90. doi: 10.5152/TJAR.2016.20981. Epub 2016 Apr 1.
Pain from rocuronium injection is observed in 50%-80 % of patients. This study aimed to compare the effectiveness of pretreatment with paracetamol and lidocaine in preventing pain-induced withdrawal caused by the intravenous injection of rocuronium during the induction of general anaesthesia in paediatric patients.
Ninety children were randomized into two groups using a simple drawing from the box method: a paracetamol group (Group P, n=45) and a lidocaine group (Group L, n=45). After anaesthesia induction, venous occlusion was applied by a paediatric cuff inflated to a pressure of 75 mmHg and by 50 mg paracetamol and 0.5 mg kg(-1) lidocaine was injected in Groups P and L, respectively. Venous occlusion was then released, followed by rocuronium injection (0.6 mg kg(-1)). Withdrawal was evaluated using a 4-point scale (1, no response; 2, movement at the wrist only; 3, movement/withdrawal involving arm only (elbow/shoulder) and 4, generalized response, movement/withdrawal in more than one extremity).
The incidence of withdrawal movement was 42% and 26% in the Groups P and L, respectively (p=0.120). Although no significant differences were noted in the number of patients who had no withdrawal movement and mild withdrawal movement in Groups P and L, compared with Group L, the incidences of moderate withdrawal movement were significantly higher in Group P (p<0.05). No patient in either group revealed generalized movement.
Using a venous occlusion technique, pretreatment with 50 mg paracetamol can prevent withdrawal movement caused by rocuronium injection in children but is not as effective as lidocaine to prevent moderate withdrawal movement.
50%-80%的患者在注射罗库溴铵时会出现疼痛。本研究旨在比较对乙酰氨基酚和利多卡因预处理在预防小儿全身麻醉诱导期间静脉注射罗库溴铵引起的疼痛性退缩反应方面的有效性。
采用从盒子中简单抽取的方法将90名儿童随机分为两组：对乙酰氨基酚组（P组，n = 45）和利多卡因组（L组，n = 45）。麻醉诱导后，使用儿科袖带充气至75 mmHg的压力进行静脉闭塞，P组和L组分别注射50 mg对乙酰氨基酚和0.5 mg/kg利多卡因。然后松开静脉闭塞，接着注射罗库溴铵（0.6 mg/kg）。使用4分制量表评估退缩反应（1分，无反应；2分，仅手腕部有动作；3分，仅手臂（肘部/肩部）有动作/退缩；4分，全身反应，一个以上肢体有动作/退缩）。
P组和L组退缩动作的发生率分别为42%和26%（p = 0.120）。虽然P组和L组中无退缩动作和轻度退缩动作的患者数量没有显著差异，但与L组相比，P组中度退缩动作的发生率显著更高（p<0.05）。两组均无患者出现全身动作。
采用静脉闭塞技术，50 mg对乙酰氨基酚预处理可预防儿童注射罗库溴铵引起的退缩动作，但在预防中度退缩动作方面不如利多卡因有效。
