마취유도 시 Rocuronium의 생리식염수 희석은 정주통에 의한 회피반응을 감소시킨다 (Dilution of Rocuronium with 0.9% NaCl Reduces Withdrawal Movement during Anesthetic Induction)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Anesthesia and Pain Medicine / 2권 / 1호 / 22 ~ 25페이지
· 저자명 : 김윤희

초록

Background: After induction of anesthesia with propofol or thiopental,
rocuronium causes hand or limb withdrawal or generalized
movements, suggesting the presence of intense pain even under
anaesthesia. We evaluated the effect of diluting rocuronium 10
mg/ml solution to 5 mg/ml or 3.3 mg/ml with 0.9% NaCl solution on
the withdrawal movements associated with IV administration of rocuronium
given at intubating doses after thiopental administration.
Methods: Sixty three patients undergoing surgical procedures that
required general anesthesia were randomized into three groups.
Group 1 received rocuronium 0.9 mg/kg in 10 mg/ml solution, while
Group 2 and 3 received the same dose of rocuronium in 5 mg/ml
and 3.3 mg/ml solutions with 0.9% NaCl solution after thiopental IV
administration, respectively.
Results: We observed that the incidence of withdrawal movements
was 71.4% in the Group 1, 47.6% in the Group 2 and 14.3% in the
Group 3. Intense withdrawal movements involving elbow or shoulder
and generalized movements were observed in 42.8% of patients
in Group 1, but they were seen in 23.8% of patients in Group 2 and
4.8% of patients in Group 3. There were significant differences in
incidence and degree of withdrawal movements between Group 1
and 3 (P ＜ 0.05). The pH values and osmolalities of study solutions
were not significantly different between the groups.
Conclusions: Dilution of rocuronium with 0.9% NaCl solution given
at intubating doses after thiopental administration is a simple and
cost-effective strategy for preventing withdrawal movements during
IV rocuronium injection.

영어초록

Background: After induction of anesthesia with propofol or thiopental,
rocuronium causes hand or limb withdrawal or generalized
movements, suggesting the presence of intense pain even under
anaesthesia. We evaluated the effect of diluting rocuronium 10
mg/ml solution to 5 mg/ml or 3.3 mg/ml with 0.9% NaCl solution on
the withdrawal movements associated with IV administration of rocuronium
given at intubating doses after thiopental administration.
Methods: Sixty three patients undergoing surgical procedures that
required general anesthesia were randomized into three groups.
Group 1 received rocuronium 0.9 mg/kg in 10 mg/ml solution, while
Group 2 and 3 received the same dose of rocuronium in 5 mg/ml
and 3.3 mg/ml solutions with 0.9% NaCl solution after thiopental IV
administration, respectively.
Results: We observed that the incidence of withdrawal movements
was 71.4% in the Group 1, 47.6% in the Group 2 and 14.3% in the
Group 3. Intense withdrawal movements involving elbow or shoulder
and generalized movements were observed in 42.8% of patients
in Group 1, but they were seen in 23.8% of patients in Group 2 and
4.8% of patients in Group 3. There were significant differences in
incidence and degree of withdrawal movements between Group 1
and 3 (P ＜ 0.05). The pH values and osmolalities of study solutions
were not significantly different between the groups.
Conclusions: Dilution of rocuronium with 0.9% NaCl solution given
at intubating doses after thiopental administration is a simple and
cost-effective strategy for preventing withdrawal movements during
IV rocuronium injection.

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