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Efficacies of pre-treatment with lidocaine, remifentanil and metoclopramide in the reduction of pain and withdrawal movements induced by rocuronium injection were evaluated. Forty-four adult patients, American Society of Anesthesiologists (ASA) Physical Status I–II, undergoing elective surgery were randomly assigned to four groups. Each patient received intravenously either 10 mg metoclopramide, 50 mg lidocaine, 1 μg/kg remifentanil or 3 ml of 0.9% sodium chloride (control group); followed by occlusion with a tourniquet on the forearm. After 10 s, occlusion stopped and a priming dose of 0.06 mg/kg rocuronium was injected. The patient's response to rocuronium was graded using a four-point scale in a double-blind manner. All groups had significantly lower incidences of pain compared with the control group. After loss of consciousness with sodium thiopental, 0.6 mg/kg rocuronium was administered for intubation and withdrawal movements were assessed. The number of patients in whom withdrawal movements were lowest was in the lidocaine-treated group. Although there was no difference among the study drugs in the prevention of rocuronium-induced pain, lidocaine and remifentanil seemed to be clinically more effective than metoclopramide.

A Comparison of the Efficacies of Different Pre-treatment Drugs in Resolving the Injection Pain of Rocuronium