Park Ki-Bum, Jeon Younghoon, Yi Junggu, Kim Ji-Hyun, Chung Seung-Yeon, Kwak Kyung-Hwa
Keimyoung University, School of Medicine, Department of Anesthesiology and Pain Medicine, Daegu, República da Coreia.
Kyungpook National University, School of Dentistry, Department of Anesthesiology, Daegu, República da Coreia.
Rev Bras Anestesiol. 2017 Jul-Aug;67(4):337-341. doi: 10.1016/j.bjan.2016.04.010. Epub 2016 Dec 29.
Rocuronium causes pain and withdrawal movement during induction of anesthesia. In this study, palonosetron was investigated to have analgesic effect on the reduction of rocuronium-induced withdrawal movement.
120 patients were randomly assigned to one of three groups to receive either saline, lidocaine 20mg, or palonosetron 0.075mg with a tourniquet applied two minutes before thiopental sodium (5mg.kg) was given intravenously. After loss of consciousness, rocuronium (0.6mg.kg) was injected and the withdrawal movement was estimated by 4-point scale in a double-blind manner.
The overall incidence of rocuronium withdrawal movement was 50% with lidocaine (p=0.038), 38% with palonosetron (p=0.006) compared with 75% for saline. The incidence of no pain to mild pain was significantly lower in the lidocaine and palonosetron groups (85% and 92% respectively) than in the saline group (58%). However, there was no significant difference in withdrawal movement between the lidocaine and palonosetron groups. There was no severe movement with palonosetron.
Pretreatment of palonosetron with venous occlusion may attenuate rocuronium-induced withdrawal movement as effective as the use of lidocaine. It suggested that peripheral action of palonosetron was effective to reduce rocuronium-induced withdrawal movement.
罗库溴铵在麻醉诱导期间会引起疼痛和退缩反应。在本研究中，对帕洛诺司琼减少罗库溴铵诱导的退缩反应的镇痛效果进行了研究。
120例患者被随机分为三组，分别接受生理盐水、20mg利多卡因或0.075mg帕洛诺司琼，在静脉注射硫喷妥钠（5mg/kg）前两分钟使用止血带。意识消失后，注射罗库溴铵（0.6mg/kg），并以双盲方式用4分制评估退缩反应。
与生理盐水组的75%相比，利多卡因组罗库溴铵退缩反应的总体发生率为50%（p=0.038），帕洛诺司琼组为38%（p=0.006）。利多卡因组和帕洛诺司琼组无痛至轻度疼痛的发生率（分别为85%和92%）显著低于生理盐水组（58%）。然而，利多卡因组和帕洛诺司琼组在退缩反应方面无显著差异。帕洛诺司琼组无严重反应。
静脉闭塞预处理帕洛诺司琼可能与使用利多卡因一样有效地减轻罗库溴铵诱导的退缩反应。这表明帕洛诺司琼的外周作用对减少罗库溴铵诱导的退缩反应有效。
