Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2016.04.002
Brazilian Journal of Anesthesiology
Scientific Article

The effect of palonosetron on rocuronium-induced withdrawal movement

O efeito de palonosetron sobre o movimento de retração induzido por rocurônio

Ki-Bum Park; Younghoon Jeon; Junggu Yi; Ji-hyun Kim; Seung-Yeon Chung; Kyung-Hwa Kwak

http://dx.doi.org/10.1016/j.bjane.2016.04.002 Braz J Anesthesiol, vol.67, n4, p.337-341, 2017
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Abstract

Abstract Background: Rocuronium causes pain and withdrawal movement during induction of anesthesia. In this study, palonosetron was investigated to have analgesic effect on the reduction of rocuronium-induced withdrawal movement. Methods: 120 patients were randomly assigned to one of three groups to receive either saline, lidocaine 20 mg, or palonosetron 0.075 mg with a tourniquet applied two minutes before thiopental sodium (5 mg.kg-1) was given intravenously. After loss of consciousness, rocuronium (0.6 mg.kg-1) was injected and the withdrawal movement was estimated by 4-point scale in a double-blind manner. Results: The overall incidence of rocuronium withdrawal movement was 50% with lidocaine (p = 0.038), 38% with palonosetron (p = 0.006) compared with 75% for saline. The incidence of no pain to mild pain was significantly lower in the lidocaine and palonosetron groups (85% and 92% respectively) than in the saline group (58%). However, there was no significant difference in withdrawal movement between the lidocaine and palonosetron groups. There was no severe movement with palonosetron. Conclusion: Pretreatment of palonosetron with venous occlusion may attenuate rocuronium-induced withdrawal movement as effective as the use of lidocaine. It suggested that peripheral action of palonosetron was effective to reduce rocuronium-induced withdrawal movement.

Keywords

Palonosetron, Rocuronium, Injection, Pain, Withdrawal movement

Resumo

Resumo Justificativa: Rocurônio provoca dor e reflexo de retirada durante a indução da anestesia. Neste estudo, avaliamos se palonosetron tem efeito analgésico para reduzir esse movimento induzido por rocurónio. Métodos: Cento e vinte pacientes foram randomicamente designados para um de três grupos para receber solução salina, lidocaína (20 mg) ou palonosetron (0.075 mg), com aplicação de torniquete dois minutos antes da administração intravenosa de tiopental sódico (5 mg.kg-1). Após a perda de consciência, rocurônio (0.6 mg.kg-1) foi injetado e o reflexo de retirada foi avaliado com o uso de uma escala de quatro pontos, de modo duplo-cego. Resultados: A incidência global do reflexo de retirada induzido por rocurônio foi de 50% para lidocaína (p = 0,038), 38% para palonosetron (p = 0,006), em comparação com 75% para solução salina. A incidência de dor ausente ou leve foi significativamente menor nos grupos lidocaína e palonosetron (85% e 92%, respectivamente) que no grupo solução salina (58%). Porém, não houve diferença significativa no reflexo de retirada entre os grupos lidocaína e palonosetron. Não houve movimento grave com palonosetron. Conclusão: O pré-tratamento com palonosetron com oclusão venosa pode atenuar o reflexo de retirada induzido por rocurônio de modo tão eficaz como o uso de lidocaína. Sugeriu-se que a ação periférica de palonosetron foi eficaz para reduzir o reflexo de retirada induzido por rocurônio.

Palavras-chave

Palonosetron, Rocurônio, Injeção, Dor, Reflexo de retirada

References

Ahmad N, Choy CY, Aris EA. Preventing the withdrawal response associated with rocuronium injection: a comparison of fentanyl with lidocaine. Anesth Analg. 2005;100:987-90.

Memis D, Turan A, Karamanlioglu B. The prevention of pain from injection of rocuronium by ondansetron, lidocaine, tramadol, and fentanyl. Anesth Analg. 2002;94:1517-20.

Lui J, Huang S, Yang C. Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration. Chang Gung Med J. 2002;25:617-20.

Sufka KJ, Schomburg FM, Giordano J. Receptor mediation of 5-HT-induced inflammation and nociception in rats. Pharmacol Biochem Behav. 1992;41:53-6.

Tambeli CH, Oliveira MC, Clemente JT. A novel mechanism involved in 5-hydroxytryptamine-induced nociception: the indirect activation of primary afferents. Neuroscience. 2006;141:1517-24.

Bravo-Hernández M, Cervantes-Durán C, Pineda-Farias JB. Role of peripheral and spinal 5-HT3 receptors in development and maintenance of formalin-induced long-term secondary allodynia and hyperalgesia. Pharmacol Biochem Behav. 2012;101:246-57.

Ye JH, Mui WC, Ren J, Hunt TE. Ondansetron exhibits the properties of a local anesthetic. Anesth Analg. 1997;85:1116-21.

Kim SH, Hong JY, Kim WO. Palonosetron has superior prophylactic antiemetic efficacy compared with ondansetron or ramosetron in high-risk patients undergoing laparoscopic surgery: a prospective, randomized, double-blinded study. Korean J Anesthesiol. 2013;64:517-23.

Stoltz R, Cyong JC, Shah A. Pharmacokinetic and safety evaluation of palonosetron, a 5-hydroxytryptamine-3 receptor antagonist, in U.S. and japanese healthy subjects. J Clin Pharmacol. 2004;44:520-31.

Park S, Cho E. A randomized, double-blind trial of palonosetron compared with ondansetron in preventing postoperative nausea and vomiting after gynaecological laparoscopic surgery. J Int Med Res. 2011;39:399-407.

Ertugrul F. A comparison of the efficacies of different pre-treatment drugs in resolving the injection pain of rocuronium. J Int Med Res. 2006;34:665-70.

Shevchenko Y, Jocson JC, McRae VA. The use of lidocaine for preventing the withdrawal associated with the injection of rocuronium in children and adolescents. Anesth Analg. 1999;88:746-8.

Klement W, Arndt J. Pain on IV injection of some anaesthetic agents is evoked by the unphysiological osmolality or pH of their formulations. Br J Anaesth. 1991;66:189-95.

Lockey D, Coleman P. Pain during injection of rocuronium bromide. Anaesthesia. 1995;50:474.

Tuncali B, Karci A, Tuncali BE. Dilution of rocuronium to 0.5 mg/mL with 0.9% NaCl eliminates the pain during intravenous injection in awake patients. Anesth Analg. 2004;99:740-3.

Borgeat A, Kwiatkowski D. Spontaneous movements associated with rocuronium: is pain on injection the cause?. Br J Anaesth. 1997;79:382-3.

Scott R, Saunders D, Norman J. Propofol: clinical strategies for preventing the pain of injection. Anaesthesia. 1988;43:492-4.

Cheong K, Wong W. Pain on injection of rocuronium: influence of two doses of lidocaine pretreatment. Br J Anaesth. 2000;84:106-7.

Blunk J, Seifert F, Schmelz M. Injection pain of rocuronium and vecuronium is evoked by direct activation of nociceptive nerve endings. Eur J Anaesthesiol (EJA). 2003;20:245-53.

Akkaya T, Toygar P, Bedirli N. Effects of pretreatment with lidocaine or ketamine on injection pain and withdrawal movements of rocuronium. Turk J Med Sci. 2008;38:577-82.

Kim JY, Kwak HJ, Kim JY. Prevention of rocuronium-induced withdrawal movement in children: a comparison of remifentanil with alfentanil. Pediatric Anesthesia. 2008;18:245-50.

Jeon Y, Baek SU, Park SS. Effect of pretreatment with acetaminophen on withdrawal movements associated with injection of rocuronium: a prospective, randomized, double-blind, placebo controlled study. Korean J Anesthesiol. 2010;59:13-6.

Gregory RE, Ettinger DS. 5-HT3 receptor antagonists for the prevention of chemotherapy-induced nausea and vomiting. A comparison of their pharmacology and clinical efficacy. Drugs. 1998;55:173-89.

Zeitz KP, Guy N, Malmberg AB. The 5-HT3 subtype of serotonin receptor contributes to nociceptive processing via a novel subset of myelinated and unmyelinated nociceptors. J Neurosci. 2002;22:1010-9.

Ernberg M, Lundeberg T, Kopp S. Pain and allodynia/hyperalgesia induced by intramuscular injection of serotonin in patients with fibromyalgia and healthy individuals. Pain. 2000;85:31-9.

Reddy MS, Chen FG, Ng HP. Effect of ondansetron pretreatment on pain after rocuronium and propofol injection: a randomised, double-blind controlled comparison with lidocaine. Anaesthesia. 2001;56:902-5.

Cho K, Lee SH, Lee W. Effect of pretreatment with palonosetron on withdrawal movement associated with rocuronium injection. Korean J Anesthesiol. 2014;66:23-7.

Muchatuta NA, Paech MJ. Management of postoperative nausea and vomiting: focus on palonosetron. Ther Clin Risk Manage. 2009;5:21.

Kovac AL, Eberhart L, Kotarski J. A randomized, double-blind study to evaluate the efficacy and safety of three different doses of palonosetron versus placebo in preventing postoperative nausea and vomiting over a 72-hour period. Anesth Analg. 2008;107:439-44.

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