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Pretreatment with remifentanil to prevent withdrawal after rocuronium in children

J Y Kim1, J Y Kim, Y B Kim

  • 1Department of Anaesthesiology and Pain Medicine, Ajou University College of Medicine, Suwon, Korea.

British Journal of Anaesthesia
|October 27, 2006
PubMed

Insights

Pretreating pediatric patients with remifentanil significantly reduces withdrawal movements from rocuronium injection. This method also helps maintain hemodynamic stability during anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacology

Background:

  • Rocuronium injection frequently causes pain and withdrawal responses in pediatric patients.
  • Existing methods for mitigating this side effect are limited.

Purpose of the Study:

  • To evaluate the efficacy of intravenous remifentanil as a pretreatment to prevent withdrawal responses during rocuronium injection in children.

Main Methods:

  • A randomized, double-blind, placebo-controlled study involving 70 pediatric patients.
  • Patients received either intravenous remifentanil (1 mug/kg) or saline before rocuronium injection.
  • Hemodynamic parameters (MAP, heart rate) were monitored throughout the procedure.

Main Results:

  • The incidence of withdrawal movements was significantly lower in the remifentanil group (23%) compared to the saline group (94%).
  • No generalized movements were observed in the remifentanil group, unlike 51% in the saline group.
  • Remifentanil pretreatment prevented significant increases in Mean Arterial Pressure (MAP) post-intubation.

Conclusions:

  • Intravenous remifentanil at 1 microg/kg is a safe and effective pretreatment for reducing rocuronium-induced withdrawal movements in children.
  • Remifentanil administration ensures hemodynamic stability during anesthesia induction and maintenance.
Abstract

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