The use of lidocaine for preventing the withdrawal associated with the injection of rocuronium in children and adolescents

We designed this study to examine the incidence and degree of movement afte r the administration of rocuronium in children and adolescents and to measu re the treatment effect of lidocaine for its prevention. One hundred patien ts (aged 5-18 yr) were randomly assigned to two groups. After general anest hesia was induced with 5 mg/kg thiopental sodium and manual occlusion of ve nous outflow was performed, one group of patients received 0.1 mL/kg 1% Lid ocaine TV. A second group received 0.1 mL/kg of isotonic sodium chloride so lution as a placebo control. Venous outflow occlusion was held for 15 s, re leased, and immediately followed by the administration of rocuronium 1 mg/k g IV. The patient's response to rocuronium injection was graded using a 4-p oint scale. We observed that the incidence of withdrawal was 84% in the pla cebo group and was significantly decreased to 46% in patients pretreated wi th lidocaine (P < 0.001). This study demonstrates that the TV injection of rocuronium is commonly associated with a withdrawal reaction in anesthetize d pediatric patients and that this reaction can be attenuated or eliminated by pretreatment with IV lidocaine. Implications: Pain on injection of rocu ronium in pediatric patients can be alleviated by pretreatment with IV lido caine.