Preventing the withdrawal response associated with rocuronium injection: a comparison of fentanyl with lidocaine

Anesth Analg. 2005 Apr;100(4):987-990. doi: 10.1213/01.ANE.0000147790.76114.3A.

Abstract

We compared the efficacy of IV fentanyl with IV lidocaine as pretreatment for the prevention of withdrawal response after rocuronium injection. For this prospective, randomized, placebo-controlled, double-blind study we recruited 90 patients aged between 18 and 65 yr, ASA physical status I or II, who had undergone elective surgery requiring general anesthesia and positive pressure ventilation. Patients were randomly allocated to 1 of 3 groups: group F received 2 mL IV fentanyl 50 microg/mL (100 microg), group L received 2 mL of preservative-free lidocaine 2% (40 mg), and group P (placebo) received 2 mL of normal saline. The incidence of withdrawal response after rocuronium was 57%, 30%, and 7% in the placebo, lidocaine, and fentanyl groups, respectively. We found a significant reduction in incidence of withdrawal response in both the fentanyl and lidocaine groups when compared with the placebo group (P < 0.05), with the fentanyl group being most effective (P < 0.05). In conclusion, both fentanyl and lidocaine are effective clinical treatments to alleviate the withdrawal response associated with rocuronium injection, with fentanyl being more effective.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Androstanols / administration & dosage
  • Androstanols / adverse effects*
  • Anesthesia, General
  • Anesthetics, Intravenous / administration & dosage
  • Anesthetics, Intravenous / therapeutic use*
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use*
  • Double-Blind Method
  • Female
  • Fentanyl / administration & dosage
  • Fentanyl / therapeutic use*
  • Humans
  • Lidocaine / administration & dosage
  • Lidocaine / therapeutic use*
  • Male
  • Middle Aged
  • Neuromuscular Nondepolarizing Agents / administration & dosage
  • Neuromuscular Nondepolarizing Agents / adverse effects*
  • Prospective Studies
  • Rocuronium
  • Substance Withdrawal Syndrome / prevention & control*

Substances

  • Androstanols
  • Anesthetics, Intravenous
  • Anesthetics, Local
  • Neuromuscular Nondepolarizing Agents
  • Lidocaine
  • Fentanyl
  • Rocuronium