Prevention of pain on injection of rocuronium: a comparison of lidocaine with different doses of parecoxib

Study objective: To compare the efficacy of pretreatment with parecoxib and lidocaine to prevent rocuronium injection pain.

Design: Prospective, randomized, double-blinded study.

Setting: Academic medical center.

Patients: 160 adult ASA physical status 1 and 2 patients scheduled for elective surgery.

Interventions: Patients were randomly allocated to 4 groups of 40 patients each to receive pretreatment with normal saline (Group C), parecoxib 20 mg (Group P(20)), parecoxib 40 mg (Group P(40)), or lidocaine 40 mg (Group L). All groups underwent venous occlusion for two minutes before rocuronium was injected.

Measurements: Pain scores were obtained by a study-blinded observer immediately after the pretreatment.

Main results: The frequency of rocuronium injection pain in the saline group (80%) was significantly higher than in Group P(20) (55%), Group P(40) (20%), and Group L (25%) (P < 0.05). The frequency and intensity of rocuronium-induced pain were statistically similar between Group P(40) and Group L. In the parecoxib 40 mg and lidocaine 40 mg groups, the frequency of pain was significantly less than in the parecoxib 20 mg group (P < 0.05).

Conclusion: Pretreatment with parecoxib and lidocaine was effective in reducing the frequency and severity of pain with rocuronium injection whereas pretreatment with parecoxib 40 mg and lidocaine 40 mg were the most effective treatments.