comparison of granisetron and nitroglycerine for attenuating rocuronium pain: a double-blinded randomized, placebo controlled trial

The incidence of pain reported in literature after IV administration of rocuronium is 50-80%. The aim of our study was to determine whether pre-treatment with intravenous granisetron and nitroglycerine would reduce rocuronium-induced pain. One hundred fifty patients of either sex, aged 18-65 years, American society of Anaesthesiologist grading [ASA] I-II, scheduled for various surgeries under general anesthesia were randomly assigned to one of the groups. Group G: received 2 granisetron [1mg/ml] diluted with 3 ml of 0.9% normal saline] while the Group C: received 5 ml of 0.9% normal saline. Group N: received 200 micro g of nitroglycerine diluted to a total of 5 ml[with 0.9% normal saline]. It was accompanied by manual venous occlusion for 20 seconds. Then 0.06mg/kg of rocuronium was injected through same cannula over 10-15 sec.Patients were asked by a blinded investigator to score the pain on injection of rocuronium using visual analogue scale [0-10] with 0-no pain,1-3 mild pain, 4-6 moderate and >=7 severe pain. At the same time discomfort in the form of patient's movement, such as no movement [grade 0], movement only wrist [grade 1], movement to the upper arm and shoulder of injected arm [grade 2] or generalized movements [grade3] was observed. Statistical analysis using independent t test, Mann-Whitney test and reverse ANOVA was done. 1. At 0 seconds, in group G number of patients who experienced with drawl score of 0-1 were 92%,group N were 82% while only 26% of patients in group C had favourable with drawl score.74% of patients in group C had score of 2-3 at same time. 2. At 0 sec, in group G number of patients who experienced VAS score of 0-3 were 96%, group N 72%. At same time Group C 48% of patients had VAS score of 2-3. We conclude that pre-treatment with granisetron or nitroglycerine both are highly effective in attenuation of rocuronium induced pain

Intra and postoperative outcome of adding clonidine to bupivacaine in infraorbital nerve block for young children undergoing cleft lip surgery

To evaluate the efficacy of adding clonidine to bupivacaine in bilateral infraorbital nerve block for hemodynamic changes, requirement of opioids, volatile agent, and muscle relaxants intraoperatively and relief of pain postoperatively . Prospective, randomized, double-blind study. Fifty pediatric patients aged less than 24 months undergoing elective cleft lip repair were randomly allocated to two groups of 25 each. After tracheal intubation, group A received bilateral infraorbital nerve block with 1 ml solution of clonidine [1 micro g/kg] and bupivacaine 0.25%, and group B received 1 ml of 0.25% bupivacaine. Hemodynamic parameters, intraoperative requirement of volatile anesthetic agent, muscle relaxant, and analgesic were recorded. Pain was assessed postoperatively using the Face, Legs, Activity, Cry, Consolability scale till the first rescue drug was given. Two sample unpaired t-test and the correlation r test. The duration of analgesia from the time of administration of block in group A was 667.72 +/- 210.74 min compared to 558.48 +/- 150.28 min in group B [P<0.05]. Addition of clonidine as an adjunct to local anesthetic significantly decreased the requirement of other anesthetic drugs and significantly prolonged the duration of postoperative analgesia without any adverse effects