comparison of fentanyl, meperidine and lidocaine in preventing the withdrawal response associated with rocuronium injection

We compared the efficacy of IV fentanyl, IV meperidine and IV lidocaine as pretreatment for the prevention of withdrawal response after rocuronium injection. For this prospective, randomized, placebo-controlled, double-blinded study we recruited 120 patients aged between 18 and 65 years, ASA physical status I or II, who had undergone elective surgery requiring general anesthesia and positive pressure ventilation. Patients were randomly allocated to 1 of 4 groups; group F received 2ml IV fentanyl 50micro g/ml [100 micro g], group M received 0.5ml IV meperidine [25mg], group L received 2ml of preservative-free lidocaine 2% [40mg] and group P [placebo] received 2 ml of normal saline. The incidence of withdrawal response after rocuronium was 56%, 16%, 15% and 7% in the placebo, lidocaine, meperidine and fentanyl groups respectively. We found a significant reduction in incidence of withdrawal response in the fentanyl, meperidine and lidocaine groups when compared with the placebo group [p<0.05], with the fentanyl group being most effective [p<0.05]. In conclusion, it was found that fentanyl, meperidine and lidocaine are effective clinical treatments to alleviate the withdrawal response associated with rocuronium injection, with the fentanyl being the most effective of the three used drugs

Postoperative emesis in pediatric strabismus correction

Postoperative emesis after strabismus surgery continues to be a problem, despite the use of anti emetic. The purpose of this study was to identify an anesthetic technique associated with the lowest incidence of vomiting after pediatric surgery. A prospective, randomized, double-blind study was conducted to evaluate the effect of intravenous, sufentanil, morphine,or peribulbar block with propofol infusion on emesis in 105 pediatric patients undergoing strabismus correction. Anesthesia was maintained with air, oxygen and propofol infusion diclofcnac sodium 1mg/kg intramuscular was administered to all patients after induction patients was given either a peribulbar block, intravenous sufentanil 0.25 micro g/kg or intravenous morphine 0.1 mg/kg for perioperative analgesia. The emesis score was observed for the first 24 hours postoperatively. The incidence of emesis was significantly lower [1 of 35:2.9%] in the peribulbar group compared with morphine group [9 of 35:25.6%] [P<0.1]. The sufentanil group had a higher incidence of vomiting [4 of 35:11.4%] than did the peribulbar group. Among three techniques, peribulbar block with propofol - based anesthesia is the technique with the lowest incidence of postoperative emesis. Sufentanil-propofol is equally acceptable alternative however morphine- propofol is associated with high incidence of postoperative emesis

comparative study between pre-emptive peribulbar block and intravenous fentanyl in pediatric vitreoretinal surgery

In a prospective, randomized, single-blind study, 90 children [ages 7-14 years] were allocated to receive peribulbar block [n = 45] or intravenous fentanyl 1 mg/kg [n = 45] after the induction of general anesthesia. The number of children requiring intraoperative supplemental analgesia, number of incidence of oculocardiac reflex, requirement for additional analgesic, postoperative pain intensity, emetic episodes and parental assessment of the child's postoperative comfort at 24 hours were compared. The study concluded that peribulbar block appears to be safer and of a clinical superiority over the use of intravenous fentanyl for pediatric VR surgery