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Rocuronium-induced withdrawal movements associated with different Rocuronium injection method

Seung-Hoon Baek1, Chul-Min Woo, Hyeon-Jeong Lee

  • 1Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea.

Paediatric Anaesthesia
|March 4, 2008
PubMed

Insights

Infusing rocuronium (a muscle relaxant) significantly reduces withdrawal movements during tracheal intubation in children. This method is as effective as bolus injection for intubation and muscle relaxation, offering a more comfortable experience.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacology

Background:

  • Rocuronium bolus injections commonly cause pain and withdrawal movements in pediatric patients.
  • Minimizing patient discomfort during anesthesia induction is a key clinical goal.

Purpose of the Study:

  • To compare the incidence and intensity of rocuronium-induced withdrawal movements between intravenous bolus and infusion injections in children.
  • To evaluate the impact of different rocuronium administration methods on intubating conditions and muscle relaxation onset.

Main Methods:

  • 120 pediatric patients (3-15 years) were randomized into four groups receiving either bolus or infusion rocuronium (0.6 or 0.9 mg/kg).
  • Withdrawal movements were assessed using a 4-grade scale, and intubating conditions were evaluated.
  • Rocuronium-induced muscle relaxation time was measured via single twitch stimulation.

Main Results:

  • Infusion administration significantly reduced both the incidence (33.3% vs. 100%) and intensity of withdrawal movements compared to bolus injection (P < 0.05).
  • All groups achieved clinically acceptable to excellent intubating conditions.
  • No significant differences in muscle relaxation duration were observed between bolus and infusion groups.

Conclusions:

  • Infusion rocuronium effectively reduces injection-related withdrawal movements in children undergoing tracheal intubation.
  • Rocuronium infusion does not compromise intubating conditions or delay the onset of muscle relaxation.
  • Infusion administration represents a more comfortable alternative for rocuronium delivery in pediatric anesthesia.
Abstract

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