• Seung-Hoon Baek, Chul-Min Woo, Hyeon-Jeong Lee, Ji-Young Yoon, Jae-Young Kwon, and Sang-Wook Shin.
• Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea.
• Paediatr Anaesth. 2008 Jun 1;18(6):515-9.

ObjectivesOne hundred and twenty patients (3-15 years old) were randomly enrolled (four groups: each group = 30 patients) in the study.AimThe aim of this study was to compare the incidence and intensity of rocuronium-induced withdrawal movements in children injected with a typical intravenous bolus injection of rocuronium or with an infusion injection of rocuronium.BackgroundIntravenous bolus injection of rocuronium produces pain and withdrawal movement.MethodsImmediately after loss of consciousness by thiopental sodium (5 mg x kg(-1)), 0.6 mg x kg(-1) (B0.6, I0.6) or 0.9 mg x kg(-1) rocuronium (B0.9, I0.9) was injected by different method, either a bolus injection over 5 s (B0.6, B0.9) or an infusion injection lasting for 1 min (I0.6, I0.9). The withdrawal movement of the patients to the injection of rocuronium was assessed (four-grade score: 0-3). Intubating condition was assessed. Rocuronium-induced muscle relaxation time was measured by single twitch stimulation fade out.ResultsThe incidence (group B: 100%, group I: 33.3%) and the intensity of the withdrawal movements were significantly lower in the infusion groups compared with the bolus groups (P < 0.05). The intubating conditions for all groups were clinically acceptable (good to excellent). There was no significant difference in the muscle relaxation time between the different injection groups (I0.6; 105.6 +/- 7.7 vs B0.6; 114.6 +/- 8.0, I0.9; 69.2 +/- 3.6 vs B0.9; 73.4 +/- 1/0).ConclusionsThe infusion injection of rocuronium for tracheal intubation significantly reduced the incidence and intensity of withdrawal movement on injection of rocuronium, and it neither delays the onset of muscle relaxation nor deteriorates the intubating condition.

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