Vital Capacity Induction with Sevoflurane in Children Results in Less Incidence of Withdrawal after Rocuronium than Tidal Volume Induction / 대한마취과학회지

BACKGROUND: The Vital capacity technique is known to have some advantages over the tidal volume technique during inhalation induction of anesthesia.The aim of this study was to compare the incidence of withdrawal movement associated with the intravenous administration of rocuronium 0.3 mg/kg in children during inhalation induction with sevoflurane using the tidal volume and vital capacity techniques. METHODS: We randomly assigned 130 patients (aged 5-12 years) to either tidal volume (group T) or vital capacity (group V) groups for inhalation induction with sevoflurane.Rocuronium 0.3 mg/kg was administrated after loss of the eyelash reflex.The time to loss of the eyelash reflex was recorded and adverse events during induction were documented.The patient's response to rocuronium injection was graded using a four-point scale. RESULTS: No significant differences were observed between the groups with respect to age, weight, and gender.The time to loss of the eyelash reflex was more rapid in group V than in group T (P < 0.05).Excitatory movement developed more frequently in group T, and no significant differences were found in the incidence of other adverse events between the groups.The incidence of withdrawal movement associated with the injection of rocuronium was significantly lower in group V compared to group T (30 vs. 60%; P < 0.05). CONCLUSIONS: Inhalation induction with sevoflurane using the vital capacity technique decreased the incidence of withdrawal movement during the injection of rocuronium compared to the tidal volume technique.

The Effect of 30 Min Pre-treatment with Continuous Lidocaine Infusion on Propofol-induced Pain / 대한마취과학회지

BACKGROUND: Pain on injection is one of the major disadvantages of propofol. To solve this problem, many investigations have been done. We postulated that the duration of pre-treatment of local anesthetics might affect the incidence and nature of injection pain. METHODS: Seventy seven patients were involved in our study. They were divided into control group (group C, n = 25); pre-treatment with normal saline and study group (n = 52); pre-treatment with 0.1% lidocaine 1 ml/kg/h for 30 min before propofol injection. The study group was subdivided into 2 groups, one receiving maintenance fluid (group LF, n = 28) and one not (group LS, n = 24). A vein on the dorsum of the hand was used for the intravenous line in all patients. Pain assessment was made twice, immediately after injection of first half dose of propofol and after injection of the remaining half dose. The speed of propofol injection was 0.5 ml/sec. After measuring pain with the visual analogue scale (VAS) and pain scoring (PS) during propofol injection, the highest score in each case was used for comparison. RESULTS: The values of VAS and PS of group LF were not different from group C. However the corresponding values of group LS were lower than those of group C (P<0.05). CONCLUSIONS: From our results, it can be suggested that the duration of 30 min pre-treatment of lidocaine without maintenance fluid is one method for reducing the incidence and nature of pain induced by propofol.