Effects of pretreatment with esmolol and lidocaine on injection pain and rocuronium-induced withdrawal response

• Published in: Turkish journal of medical sciences Vol. 45; no. 4; pp. 959 - 963
• Main Authors: Ergil, Jülide, Kavak Akelma, Fatma, Özkan, Derya, Bumin Aydin, Gözde, Gürel, Ayşe, Akinci, Melih
• Format: Journal Article
• Language: English
• Published: Turkey 01-01-2015
• Subjects: Adrenergic beta-1 Receptor Antagonists - administration & dosage; Adult; Androstanols - administration & dosage; Androstanols - adverse effects; Anesthesia, General - methods; Anesthetics, Intravenous - administration & dosage; Double-Blind Method; Drug Monitoring; Female; Humans; Injections, Intravenous; Lidocaine - administration & dosage; Male; Middle Aged; Neuromuscular Nondepolarizing Agents - administration & dosage; Neuromuscular Nondepolarizing Agents - adverse effects; Pain - chemically induced; Pain - prevention & control; Pain Measurement - methods; Propanolamines - administration & dosage; Propofol - administration & dosage; Substance Withdrawal Syndrome - prevention & control; Surgical Procedures, Operative - methods; Treatment Outcome
• ISSN: 1300-0144
• DOI: 10.3906/sag-1311-79

We aimed to compare the effectiveness of esmolol 1 mg/kg and lidocaine 1 mg/kg for injection pain and for the prevention of rocuronium-induced withdrawal response.
We enrolled a total of 81 patients in the study. Patients were randomly assigned to receive either 10 mL of 0.9% NaCl (Group P), esmolol 1 mg/kg (Group E), or lidocaine 1.0 mg/kg (Group L). A subparalyzing dose of rocuronium 0.05 mg/ kg was administered to all patients and its effects were recorded. Anesthesia was induced with intravenous propofol and intravenous rocuronium 0.5 mg/kg in all groups. The withdrawal movements of the patient groups were subsequently graded.
There was a statistically significant difference in overall incidence of pain in group E and L compared to the placebo group after administrating the subparalyzed dose (no pain response: Group E = 81.5%, Group L = 77.8%, Group P = 14.8%) (P < 0.001). After intravenous administration of an intubating dose of rocuronium, the esmolol group had a significantly lower incidence of withdrawal movement than the other groups (no response: Group E = 81.5%, Group L = 63%, Group P = 22.2%) (P < 0.001).
We found that esmolol significantly attenuates rocuronium-induced withdrawal movement and also reduces pain when used at subparalyzing doses.