Comparıson of the effects of rocuronıum bromıde wıth dıfferent temperatures on ıntravenous ınjectıon paın and neuromuscular blockage duratıon

In this study we aimed to investigate the effect of +4º C and +22 º C rocuronium bromide and rocuronium bromide-lidocaine mixtures on injection pain and neuromuscular blockade duration with arm withdrawal motion and neuromuscular monitorization respectively.We performed this study on patients with ASA I-II risk category who were undergoing rhinoplasty procedure with general anesthesia. 120 patients with the ages of 18-65 years old were included in the study. Proper intraoperative monitorization was carried out based on the ASA standarts and also neuromuscular monitorization was performed with TOF Watch SX? device. The patients were randomly subdivided into 6 groups based on different temparatures and addition of isotonic saline or lidocaine. The injection solutions for the groups were; Group I: (n=20) +4 ºC rocuronium bromide, Group II: (n=20) +4 ºC rocuronium bromide + 2 mL isotonic saline, Group III: (n=20) +4 ºC rocuronium bromide + 2 mL 2% lidocaine, Group IV: (n=20) +22 ºC rocuronium bromide, Group V: (n=20) +22 ºC rocuronium bromide + 2 mL isotonic saline, GroupVI: (n=20) +22 ºC rocuronium bromide + 2 mL 2% lidocaine.After injection of 5 mg kg-1 sodium thiopenthale, different rocuronium bromide solutions which were previously prepared for Goups I-VI were injectedwith the dosage of 0.6 mg kg-1 in 10-15 seconds for induction anesthesia. The pain induced by rocuronium bromide injection was determined by the `scale of arm withdrawal?. Endotracheal intubation was performed after 100% neuromuscular blockage (T0). Maintanance anesthesia was carried on with 0.05-0.2 ?g kg-1 min-1 remifentanyl, 1-2% sevoflurane. The hemodynamic parameters and the TOF percentage values were recorded in every five minutes. The durations were recorded until TOF became 25%, 50% and 75%.There wasn?t significant difference between the pH and osmolality values of the neuromuscular blockade solutions of either group. After neuromuscular blocker injection, arm withdrawal wasn?t seen in 30% of Group I, 25% of Group II, 70% of Group III, 20% of Group IV, 30% of Group V and 20% of Group VI. The frequency of arm withdrawal was least in in Group III. TOF duration was comparable among the groups.In conclusion, 2% lidocaine solution added to +4ºC rocuronium bromide was superior to other groups for reduction of injection induced pain. Rocuronium bromide solutions with different temparatutes was similar by the means of neuromuscular blockade durations.