Spontaneous movements, local reactions and pain on injection of rocuronium- A comparison between female and male patients

Background: We investigated the incidence of withdrawal, local reactions an d pain on injection of rocuronium in 120 adult ASA I-H patients undergoing general anaesthesia (group A: 60 male patients, group B: 60 female patients ). Methods: After induction of anaesthesia with propofol and remifentanil, roc uronium 0.6 mg kg(-1) was injected in a separate intravenous cannula on the opposite arm. The patient's response to the injection of rocuronium was gr aded using a four-point scale. The appearance of local signs (i.e. erythema , venous sequelae) on the arm where rocuronium had been injected was record ed at the end of the injection as well as I h and 24 h after recovery from anaesthesia. Moreover, patients were asked 24 h after recovery from anaesth esia whether they had recall of pain or movements in this arm during induct ion of anaesthesia. Results: In 26 of the 120 patients (22%) included, withdrawal reactions aft er injection of rocuronium were observed. Of these 26 patients, 16 (13%) ha d severe movements. The overall incidence of withdrawal reactions after roc uronium as well as the incidence of severe reactions was significantly high er in female patients compared to male patients (overall incidence: 18 fema les (30%) vs. 8 males (13%), P <0.05; severe reaction: 13 females (22%) vs. 3 males (5%), P <0.05). No local reactions were observed and no patient re membered any pain or movements during induction of anaesthesia. Conclusion: The incidence and the degree of withdrawal reactions in respons e to the injection of rocuronium were significantly higher in women than in men. This was not associated with adverse clinical consequences for the pa tient's outcome.