• A Borgeat, D Kwiatkowski, and Y A Ruetsch.
• Department of Anesthesiology, University Clinic of Zurich/Balgrist, Switzerland.
• J Clin Anesth. 1997 Dec 1;9(8):650-2.

Study ObjectiveTo determine if prior injection of fentanyl decreases the incidence of spontaneous movements during rocuronium administration.DesignProspective, randomized, double-blind, placebo-controlled study.SettingUniversity orthopedic surgical center.Patients122 ASA physical status I and II patients scheduled for elective orthopedic surgery.InterventionsPatients randomly received 2 micrograms/kg of fentanyl or the equivalent volume of NaCl 0.9% 45 seconds prior to induction of anesthesia. Induction was performed with propofol 2.5 mg/kg followed by rocuronium 0.8 mg/kg 60 seconds later. Spontaneous movements were scored as follows: a) limited to the hand, b) limited to the elbow, and c) involving the whole arm, including the shoulder.Measurements And Main ResultsPrior injection of fentanyl (2 micrograms/kg significantly decreased the incidence of spontaneous movements limited to the hand: 5% versus 20% (p < 0.05); limited to the elbow: 1% versus 25% (p < 0.05); and involving the whole arm: none versus 12% (p < 0.05). No erythema or any change in the skin surrounding the point of injection of the involved arm was observed. Twenty-four hours later, no vein induration was present and no patient complained of any residual pain.ConclusionPrior injection of fentanyl significantly decreases the incidence of spontaneous movements associated with rocuronium administration.

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