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KMID : 0356920140670030175
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Korean Journal of Anesthesiology
2014 Volume.67 No. 3 p.175 ~ p.180
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Effects of lidocaine, ketamine, and remifentanil on withdrawal response of rocuronium
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Jung Ki-Tae
Kim Hye-Ji
Bae Hyo-Sung
Lee Hyun-Young
Kim Sang-Hun
So Keum-Young
Lim Kyung-Jun
Yu Byung-Sik
Jung Jong-Dal
An Tae-Hun
Park Hong-Chan
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Abstract
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Background: Rocuronium has been well known to produce withdrawal response in 50-80% patients when administered intravenously. Several drugs are administered prior injection of rocuronium to prevent the withdrawal response. We compared the preventive effect of lidocaine, ketamine, and remifentanil on the withdrawal response of rocuronium.
Methods: A total of 120 patients undergoing various elective surgeries were enrolled. Patients were allocated into 4 groups according to the pretreatment drugs (Group N, normal saline; Groups L, lidocaine 40 mg; Group K, ketamine 0.5 mg/kg; Group R, remifentanil 1 μg/kg). Patients received drugs prepared by dilution to 3 ml volume before injection of rocuronium. Withdrawal responses after injection of rocuronium were graded on a 4-point scale. Hemodynamic changes were observed before and after administration of pretreatment drugs and after endotracheal intubation.
Results: Incidence of withdrawal response was significantly lower in group L (20%), group K (30%), and group R (0%), than group N (87%). Severe withdrawal response was observed in 5 of the 30 patients (17%) in group L, and in 9 of the 30 patients (30%) in group K. There was no severe withdrawal response in group R. Mean blood pressure and heart rate were significantly decreased in group R compared to other groups.
Conclusions: It seems that remifentanil (1 μg/kg intravenously) was the strongest and most effective in prevention of withdrawal response after rocuronium injection among the 3 drugs.
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KEYWORD
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Ketamine, Lidocaine, Pain, Remifentanil, Rocuronium
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