Comparation of the efectiveness of pretreatment by fentanyl and remifentanil on rocuronium induced injection pain

SUMMARYComparation of the Efectiveness of Pretreatment by Fentanyl and Remifentanil onRocuronium Induced Injection PainDr. Mine Sarı, Dokuz Eylül University, Faculty of Medicine, Department of Anesthesiologyand Reanimation, Izmir/Turkey.Aim: We aimed to compare the effects of fentanyl and remifentanil pretreatments onrocuronium induced injection pain.Material and Methods: One hundred and two patients (ASA I-II; 18-60 years old) scheduledfor elective operations with general anesthesia were enrolled into this randomized, double-blind, plasebo controlled study. Standart monitoring was used. Body mass index (BMI),education level, age, sex and basal values of the patients were recorded. A 20-gaugeintravenous cannula was inserted into a vein on the patient?s nondominant hand, then 0.9%saline infusion was started and preoxygenation was performed. None of the patients receivedpremedication. Patients were divided into three similar groups. In Group R 2 mL (0.02 mg)remifentanil, in Group F 2 mL (0.1 mg) fentanyl and in Group K 2 mL 0.9% saline wereinjected in 10 sec. Following 30 sec, 10 mg rocuronium was injected in 5 sec. Pain severitywas evaluated using a five-point scale, 10 sec after the injection of rocuronium. Adverseevents observed during the study period were recorded. After anesthesia induction andintubation, maintenance of anesthesia was left to the discretion of the anesthetist.Results: Sex distribution, age of the subjects and body mass index were similar in betweeneach group. However, there was a statistically significant difference in according to the painscore (p= 0.024). Pain score of the R and K groups were significantly different (p= 0.022).Other comparisons of the pretreatment including F with K and F with R were not different.There were no correlations in between pain score, age, body mass index and educationalstatus. Adverse events were comparable between groups. The most commonly observed sideeffect was the muscle weakness which was present in 23.5% of the total group.Conclusions:Intravenous bolus administration of remifentanil was effective in preventing injection pain ofrocuronium when compared with the 0.9% saline. However, comparison of fentanyl withremifentanil and comparison of fentanyl with 0.9% saline were found to be similar inpreventing pain on rocuronium injection.Key words: rocuronium, remifentanil, fentanyl, injection pain