SPONTANEOUS MOVEMENTS ASSOCIATED WITH ROCURONIUM INJECTION - THE EFFECTS OF PRIOR ADMINISTRATION OF FENTANYL

Study Objective: To determine if prior injection of fentanyl decreases the incidence of spontaneous movements during rocuronium administrati on. Design: Prospective, randomized, double-blind, placebo-controlled study. Setting: University orthopedic surgical center. Patients: 122 A SA physical status I and II patients scheduled for elective orthopedic surgery. Interventions: Patients randomly received 2 ug/kg of fentany l or the equivalent volume of NaCl 0.9% 45 seconds prior to induction of anesthesia. Induction was performed with propofol 2.5 mg/kg followe d by rocuronium 0.8 mg/kg 60 seconds later. Spontaneous movements were scored as follows: a) limited to the hand, b) limited to the elbow, a nd c) involving the whole arm, including the shoulder. Measurements an d Main Results: Prior injection of fentanyl (2 ug/kg) significantly de creased tile incidence of spontaneous movements limited to the hand: 5 % versus 20% (p < 0.05); limited to the elbow: 1 % versus 25% (p < 0.0 5); and involving the whole arm: none versus 12% (p < 0.05). No erythe ma or any change in the shin surrounding the point of injection of the involved arm was observed. Twenty-four hours inter, no vein induratio n was present and no patient complained of any residual pain. Conclusi on: Prior injection of fentanyl significantly decreases the incidence of spontaneous movements associated with rocuronium administration. (C ) 1997 by Elsevier Science Inc.