Rokuronyum enjeksiyon ağrısının önlenmesinde bölgesel ısıtma ve lidokain enjeksiyon tekniklerinin karşılaştırılması

Abstract

Objective: Rocuronium-linked injection pain often occurs. In this study, we aimed to compare the local heating of the injection site and the iv lidocaine administration in the prevention of injection pain with rocuronium. Method: In the ASA I-II risk group, scheduled for operation in the context of general anesthesia with ethics committee approval and written approval, 60 patients aged 18-65 years were included in the study in 3 randomly assigned groups. Tourniquets were applied to the front arm in all three groups. In group 1 (n = 20) 2 ml of saline was administered iv; thirty seconds later the turnstile opened; 1 ml (10 mg) of rocuronium was applied for 2 seconds. In group 2 (n = 20) the patient's arm was warmed externally with the patient's heating blanket adjusted to 43 °C; turnstile opened at 30th; external heating was applied for a total of 1 minute; followed by 1 ml (10 mg) of rocuronium for 2 seconds. In Group 3 (n = 20), 1ml (10 mg) rocuronium was administered for 2 seconds following 2 ml of 2% lidocaine iv. Following rocuronium injection in the intubation dose, the pain was assessed by a 4-point traction response score. Results: The groups were similar in terms of demographics. The 4 point verbal rating scales were significantly different in Group 1, compared to Group 2 and Group 3 (2,0+0,8 and 0,5+0,5 and 0,3+0,4, mean+SD). There was no statistically significant difference between Groups 2 and 3. The 4 point withdrawal response scores and the number of patients who had withdrawal response were found to be significantly higher in Group 2, and no statistical difference between Groups 1 and 3. Conclusion: Local heating or lidocaine applications may be used to prevent injection pain during priming of rocuronium. We believe that both administration of lidocaine can be preferred to local heating in the prevention of rocuronium-induced mild withdrawal response at the intubation dose, and that both treatments prevent severe response.