Local Warming and Lidocaine Pretreatment Reduces Injection Pain of Rocuronium_West China Medical Journal

Authors：

ZHANG Han ,  LIU Jin

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Jin, Email: ayelene1007@gmai.com

Keywords：

罗库溴铵; 注射痛; 利多卡因; 局部加温; 止血带

Video：

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目的　比较预注射利多卡因和局部加温缓解罗库溴铵注射痛效果。方法　选取2011年3月－8月择期行腹腔镜下胆囊切除术的150例患者，按照完全随机的方法分为利多卡因组（L组）、局部加温组（W组）、对照组（C组）,每组各50例患者。W组患者在留置针部位用Bair Hugger以40 °C加温1 min；L组患者用橡胶止血带在静脉近端加压直至静脉输液停止走行，推注1%利多卡因2 mL，1 min后松开止血带。随后3组患者均在2 s内静脉推注1 mL罗库溴铵注射液（含罗库溴铵10 mg）。观察在注射罗库溴铵前预先注射利多卡因及局部加温缓解注射痛的效果。结果　罗库溴铵注射痛的发生率在W组、L组、C组中分别为62%、34%、82%。C组的疼痛发生率最高（P＜0.05）；W组的疼痛率高于L组（P＜0.05）；与W、L组相比，C组的重度疼痛率最高（P＜0.05）；L组的中、重度疼痛率低于W组（P＜0.05）。结论　预注射利多卡因和局部加温均能有效缓解罗库溴铵引起的注射痛，预注射利多卡因对于缓解罗库溴铵引起的注射痛更为有效。

Citation： ZHANG Han,LIU Jin. Local Warming and Lidocaine Pretreatment Reduces Injection Pain of Rocuronium. West China Medical Journal, 2012, 27(5): 707-710. doi: Copy

1.	夏明. 琥珀胆碱与术后肌痛[J]. 国外医学·麻醉学与复苏分册, 2001, 22(6): 326-327.
2.	Steegers MAH, Robertson EN. Pain on injection of rocuronium bromide [J]. Anesth Analg, 1996, 83(2): 203.
3.	Lockey D, Coleman P. Pain during injection of rocuronium bromide [J]. Anaesthesia, 1995, 50(4): 474.
4.	Borgeat A, Kwiatkowski D. Spontaneous movements associated with rocuronium: is pain on injection the cause? [J]. Br J Anaesth, 1997, 79(3): 382-383.
5.	Mahajan C, Rath GP, Bithal PK, et al. Local warming at injection site helps alleviate pain after rocuronium administration[J]. J Anesth, 2010, 24(6): 845-848.
6.	Liou JT, Huang SJ, Yang CY, et al. Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration [J]. Chang Gung Med J, 2002, 25(9): 617-620.
7.	Turan A, Memis D, Karamanlioglu B, et al. The prevention of pain from injection of rocuronium by magnesium sulphate，lignocaine, sodium bicarbonate and alfentanil[J]. Anaesth Intensive Care, 2003, 31(3): 277-281．.
8.	Chiarella AB, Jolly DT, Huston CM, et al. Comparison of four strategies to reduce the pain associated with intravenous administration of rocuronium[J]. Br J Anaesth, 2003, 90(3) : 377- 379.
9.	王红珠, 王军会, 王惠琴. 昂丹司琼复合利多卡因预防罗库溴铵注射痛临床分析[J]. 中国药物与临床, 2010, 10(12): 1410-1411.
10.	Klement W, Arndt JO. Pain on intravenous injection of some anesthetic agents is evoked by the unphysiological osmolality or pH of their formulations[J]. Br J Anaesth, 1991, 66(2): 189-195.
11.	Baek SH, Woo CM, Lee HJ, et al. Rocuronium induced with drawal movements associated with different rocuronium injection method[J]. Paediatric Anaesth, 2008, 18(6): 515-519.
12.	Cheong KF, Wong WH. Pain on injection of rocuronium: influence of two doses of lidocaine pretreatment[J]. Br J Anaesth, 2000, 84 (1): 106-107.
13.	Kim SK, Kwon MA, Park JS. The amount of 8.4% sodium bicarbonate needed to neutralize the acidity of rocuronium so as to prevent injection pain [J]. J Clin Anesth, 2009, 20(8): 629-630.
14.	Blunk JA, Seifert F, Schmelz M, et al. Injection pain of rocuronium and vecuronium is evoked by direct activation of nociceptive nerve endings[J]. Eur J Anaesthesiol, 2003, 20(3): 245-253.
15.	Memis D, Turan A, Karamanlioglu B, et al. The prevention of pain from injection of rocuronium by ondansetron, lidocaine, tramadol and fentanyl[J]. Anesth Analg, 2002, 94(6): 1517-1520.
16.	Fujii Y, Shiga Y. Influence of aging on lidocaine requirements for pain on injection of propofol[J]. J Clin Anesth, 2006, 18 (7): 526-529.
17.	陈伯銮. 临床麻醉药理学[M]. 北京: 人民卫生出版社, 2000: 325.

1. 　夏明. 琥珀胆碱与术后肌痛[J]. 国外医学·麻醉学与复苏分册, 2001, 22(6): 326-327.
2. 　Steegers MAH, Robertson EN. Pain on injection of rocuronium bromide [J]. Anesth Analg, 1996, 83(2): 203.
3. 　Lockey D, Coleman P. Pain during injection of rocuronium bromide [J]. Anaesthesia, 1995, 50(4): 474.
4. 　Borgeat A, Kwiatkowski D. Spontaneous movements associated with rocuronium: is pain on injection the cause? [J]. Br J Anaesth, 1997, 79(3): 382-383.
5. 　Mahajan C, Rath GP, Bithal PK, et al. Local warming at injection site helps alleviate pain after rocuronium administration[J]. J Anesth, 2010, 24(6): 845-848.
6. 　Liou JT, Huang SJ, Yang CY, et al. Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration [J]. Chang Gung Med J, 2002, 25(9): 617-620.
7. 　Turan A, Memis D, Karamanlioglu B, et al. The prevention of pain from injection of rocuronium by magnesium sulphate，lignocaine, sodium bicarbonate and alfentanil[J]. Anaesth Intensive Care, 2003, 31(3): 277-281．.
8. 　Chiarella AB, Jolly DT, Huston CM, et al. Comparison of four strategies to reduce the pain associated with intravenous administration of rocuronium[J]. Br J Anaesth, 2003, 90(3) : 377- 379.
9. 　王红珠, 王军会, 王惠琴. 昂丹司琼复合利多卡因预防罗库溴铵注射痛临床分析[J]. 中国药物与临床, 2010, 10(12): 1410-1411.
10. 　Klement W, Arndt JO. Pain on intravenous injection of some anesthetic agents is evoked by the unphysiological osmolality or pH of their formulations[J]. Br J Anaesth, 1991, 66(2): 189-195.
11. 　Baek SH, Woo CM, Lee HJ, et al. Rocuronium induced with drawal movements associated with different rocuronium injection method[J]. Paediatric Anaesth, 2008, 18(6): 515-519.
12. 　Cheong KF, Wong WH. Pain on injection of rocuronium: influence of two doses of lidocaine pretreatment[J]. Br J Anaesth, 2000, 84 (1): 106-107.
13. 　Kim SK, Kwon MA, Park JS. The amount of 8.4% sodium bicarbonate needed to neutralize the acidity of rocuronium so as to prevent injection pain [J]. J Clin Anesth, 2009, 20(8): 629-630.
14. 　Blunk JA, Seifert F, Schmelz M, et al. Injection pain of rocuronium and vecuronium is evoked by direct activation of nociceptive nerve endings[J]. Eur J Anaesthesiol, 2003, 20(3): 245-253.
15. 　Memis D, Turan A, Karamanlioglu B, et al. The prevention of pain from injection of rocuronium by ondansetron, lidocaine, tramadol and fentanyl[J]. Anesth Analg, 2002, 94(6): 1517-1520.
16. 　Fujii Y, Shiga Y. Influence of aging on lidocaine requirements for pain on injection of propofol[J]. J Clin Anesth, 2006, 18 (7): 526-529.
17. 　陈伯銮. 临床麻醉药理学[M]. 北京: 人民卫生出版社, 2000: 325.

West China Medical Journal

Local Warming and Lidocaine Pretreatment Reduces Injection Pain of Rocuronium

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