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Lee and Yoon: A Comparison of the Effect of Lidocaine or Sodium Bicarbonate Mixed with Rocuronium on Withdrawal Movement, Mean Arterial Pressure and Heart Rate during Rocuronium Injection
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2009; 39(2): 270-278.

Published online: 28 April 2009

DOI: https://doi.org/10.4040/jkan.2009.39.2.270

A Comparison of the Effect of Lidocaine or Sodium Bicarbonate Mixed with Rocuronium on Withdrawal Movement, Mean Arterial Pressure and Heart Rate during Rocuronium Injection

Sung Suk Lee1, Haesang Yoon2

1Charge Nurse, Gil Medical Center, Gachon University of Medicine & Science, Incheon, Korea.

2Professor, Department of Nursing, Gachon University of Medicine & Science, Incheon, Korea.

Address reprint requests to: Yoon, Haesang. Department of Nursing, Gachon University of Medicine & Science, 534-2 Yeonsu-dong, Yeonsu-gu, Incheon 406-812, Korea. Tel: 82-32-820-4212, Fax: 82-32-820-4201, hsyoon@gachon.ac.kr

Received 6 November 2008       Accepted 20 March 2009

Copyright © 2009 Korean Society of Nursing Science

Abstract

Purpose

This study was performed to find out the effects of lidocaine or 8.4% sodium bicarbonate mixed with rocuronium on mean arterial pressure, heart rate and withdrawal movement.

Methods

Data collection was performed from December 15, 2006 through May 31, 2007. Seventy-five patients with American Society Anesthesiologist (ASA) physical status I & II, under general anesthesia, were randomly assigned to 1 of 3 groups: R group (RG) received rocuronium 0.6 mg/kg; RL group (RLG), rocuronium 0.6 mg/kg mixed with 2 mL of 2% lidocaine; RS group (RSG), rocuronium 0.6 mg/kg with the same volume of 8.4% sodium bicarbonate. Mean arterial pressure, heart rate and withdrawal movement were observed from its injection until 5 min after endotracheal intubation.

Results

The incidence of withdrawal movement with its corresponding injections was 72%, 40% and 4% in RG, RLG and RSG, respectively (p<.001). Score of withdrawal movement was the lowest in RSG of all groups (p<.001). While mean arterial pressure (p=.011) in RSG decreased significantly, and heart rate (p=.003) in RG increased more with its injection than before induction of anesthesia.

Conclusion

Administration of the equivalent volume of 8.4% sodium bicarbonate with rocuronium is more effective than that of lidocaine with rocuronium compared with rocuronium only, in preventing withdrawal movement and in stabilizing mean arterial pressure and heart rate.

Keywords: Muscle relaxants, Rocuronium, Pain, Injection

Figures and Tables

Figure 1
Research design
jkan-39-270-g001
Table 1
Homogeneity Test for Physiologic Characteristics (N=75)
jkan-39-270-i001

SBP=systolic blood pressure; DBP=diastolic blood pressure; Con G=control group (administration of rocuronium); Exp 1G=experimental 1 group (administration of rocuronium & lidocaine); Exp 2G=experimental 2 group (administration of rocuronium & 8.4% sodium bicarbonate).

Table 2
Frequency and Level of Withdrawal Movement (N=75)
jkan-39-270-i002

Con G=control group (administration of rocuronium); Exp 1G=experimental 1 group (administration of rocuronium & lidocaine); Exp 2G=experimental 2 group (administration of rocuronium & 8.4% sodium bicarbonate); *Kruskal Wallis test.

Table 3
Mean Arterial Pressure (N=75)
jkan-39-270-i003

*p<.05; **p<.01; ***p<.001.

†comparison between Con and Exp 2G; ‡comparison between Time 1 and each Time in each group; §comparison between Time 1 and each Time in total group.

Con G=control group (administration of rocuronium); Exp 1G=experimental 1 group (administration of rocuronium & lidocaine); Exp 2G=experimental 2 group (administration of rocuronium & 8.4% sodium bicarbonate); G×T=Group×Time.

Table 4
Heart Rate (N=75)
jkan-39-270-i004

*p<.05; **p<.01; ***p<.001.

‡comparison between Time 1 and each Time in each group; §comparison between Time 1 and each Time in total group.

Con G=control group (administration of rocuronium); Exp 1G=experimental 1 group (administration of rocuronium & lidocaine); Exp 2G=experimental 2 group (administration of rocuronium & 8.4% sodium bicarbonate); G×T=Group×Time.

Notes

This study is a part of master's thesis.

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