RESUMO
Introduction: Rocuronium is a widely used monoquaternary aminosteroid nondepolarizing muscle relaxant of intermediate duration with a rapid onset to achieve optimal conditions for endotracheal intubations. The injection of rocuronium bromide during induction of anesthesia has often been associated with pain-induced withdrawal movement near the site of injection. It has been hypothesized that addition of ketorolac and Lidocaine in combination as pretreatment drugs among patients undergoing general anesthesia with rocuronium injection provides a better control of withdrawal movements in comparison to patients who receive only lidocaine. The objective of this study was to compare the efficacy of pretreatment of combination of ketorolac and Lidocaine and Lidocaine alone in the frequency of withdrawal movement associated with rocuronium injection in peripheral veins during intubation
Methodology: This study was conducted on 90 patients undergoing elective surgeries under general anesthesia in operation theater complex of our hospital. Patients were randomly divided in group A and B by lottery method. Group A received 20 mg lidocaine IV prior to rocuronium. Group B received lidocaine 20 mg and ketorolac 10 mg IV. General anesthesia was administered by induction via 5 mg/kg thiopental sodium in a separate peripheral intravenous line. Withdrawal movements were observed as mild, moderate and severe, and recorded on a well-structured performa. Efficacy was defined as no withdrawal movement on injecting rocuronium
Results: The differences in age and gender of patients were not significant in both groups and these were not associated with efficacy of treatment in the groups. However ASA status of the patients was significantly associated with efficacy of treatment groups. In Group-A 27[60%] and in Group-B 36[80%] patients had no withdrawal movement while mild movement was observed in 12[26.7%] patients in Group-A, and in 7[15.6%] patients in Group-B. Moderate movement was seen in 6[13.3%] patients in Group-A, and in 2[4.4%] patients in Group-B. The number of patients who had withdrawal movement was 18[40%] vs. 9[20%] in Group-A and Group-B respectively [p = 0.0384]. The criterion of efficacy was fulfilled by 27[60%] Group-A patients, compared to 36[80%] patients in Group-B
Conclusion: Results of this study showed that combination of intravenous lidocaine and ketorolac prior to rocuronium injection is more effective that lidocaine alone for preventing withdrawal movements for general anesthesia