Evaluation of dose effects of magnesium sulfate on rocuronium injection pain and hemodynamic changes by laryngoscopy and endotracheal intubation

• Published in: Korean journal of anesthesiology Vol. 60; no. 5; pp. 329 - 333
• Main Authors: Shin, Young Hee, Choi, Soo Joo, Jeong, Hui Yeon, Kim, Myung Hee
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Anesthesiologists 01.05.2011; Korean Society of Anesthesiologists; 대한마취통증의학회
• Subjects: cardiovascular response; Clinical; magnesium sulfate; rocuronium injection pain; tracheal intubation; 마취과학; Cardiovascular response; Magnesium sulfate; Rocuronium injection pain; Tracheal intubation
• ISSN: 2005-6419; 2005-7563
• DOI: 10.4097/kjae.2011.60.5.329

Rocuronium produces injection pain in 50-80% of treated patients. Therefore, a variety of pretreatments have been attempted to reduce this issue. We evaluated the efficacy of 3 different doses of magnesium on the rocuronium injection pain and following hemodynamic changes by laryngoscopy and tracheal intubation (LTI). Two hundreds patients, ASA I and II, undergoing general anesthesia for elective surgery were randomly divided to 4 groups: group 1, 2, 3, 4 received saline 5 ml, magnesium 5, 10 and 20 mg/kg prior to 0.6 mg/kg of rocuronium, respectively. Then, group 1 only was treated with esmolol (20 mg) before LTI. Pain intensity with rocuronium injection was assessed using a four-point scale according to patient's movement. Cardiovascular responses at baseline, after induction, 1 minutes after LTI were determined. Compared to saline, 10 and 20 mg/kg of magnesium significantly reduced the incidence of overall movement after rocuronium injection (34% and 36% in group 3 and 4, respectively vs. 76% in the group 1) (P < 0.0001). Generalized movement was seen in 4% of patients in groups 3 and 4, respectively. Compared to baseline values, diastolic blood pressure (DBP) immediately after LTI significantly increased within groups 1 and 2 (P < 0.001), but not within groups 3 and 4. Magnesium (10 and 20 mg/kg) prior to rocuronium was effective in attenuating rocuronium associated injection pain and cardiovascular changes by LTI.