Comparison of lidocaine and a combination of lidocaine and ketorolac pretreatment on withdrawal movement induced by rocuronium injection

Abstract

Introduction: Rocuronium is a widely used monoquaternary aminosteroid nondepolarizing muscle relaxant of intermediate duration with a rapid onset to achieve optimal conditions for endotracheal intubations. The injection of rocuronium bromide during induction of anesthesia has often been associated with pain-induced withdrawal movement near the site of injection. It has been hypothesized that addition of ketorolac and Lidocaine in combination as pretreatment drugs among patients undergoing general anesthesia with rocuronium injection provides a better control of withdrawal movements in comparison to patients who receive only lidocaine. The objective of this study was to compare the efficacy of pretreatment of combination of ketorolac and Lidocaine and Lidocaine alone in the frequency of withdrawal movement associated with rocuronium injection in peripheral veins during intubation.

Methodology: This study was conducted on 90 patients undergoing elective surgeries under general anesthesia in operation theater complex of our hospital. Patients were randomly divided in group A and B by lottery method. Group A received 20 mg lidocaine IV prior to rocuronium. Group B received lidocaine 20 mg and ketorolac 10 mg IV. General anesthesia was administered by induction via 5 mg/kg thiopental sodium in a separate peripheral intravenous line. Withdrawal movements were observed as mild, moderate and severe, and recorded on a well-structured performa. Efficacy was defined as no withdrawal movement on injecting rocuronium.