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Published in: Journal of Anesthesia 3/2018

01-06-2018 | Original Article

The evaluation of the effect of venous diameter measurement by ultrasonography on pain and withdrawal response

Authors: Sinan Yılmaz, Yasemin Hatiboğlu

Published in: Journal of Anesthesia | Issue 3/2018

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Abstract

Purpose

Rocuronium and propofol are used in the induction of anesthesia give discomfort to the patients. We aimed to investigate the relationship between venous diameter measured using ultrasonography, and pain and withdrawal movements after propofol and rocuronium applied with intravenous (IV).

Methods

This prospective-observational study was performed on 142 voluntary patients undergoing surgical operation under general anesthesia. An ultrasonography was used to measure the vein transverse diameter. Patients with a venous transverse diameter of ≤2 mm were classified as group 1 (n = 50), while patients with a diameter of > 2 mm were classified as group 2 (n = 92). The propofol pain was assessed according to the verbal rating scale (VRS). In addition, the withdrawal movements of the rocuronium injection were evaluated using the four-point scale.

Results

There was no difference between the two groups in terms of the demographic data. The patients have pain after propofol 38.2% and withdrawal movements after rocuronium 42.4% were detected. The maximum number of patients without pain after propofol injection (78.2%) and without withdrawal movements after rocuronium (76%) was found to be higher in group 2 (p = 0.001).

Conclusion

In this study, we found a reduction in the incidence and severity of pain and withdrawal movements in intravenous propofol and rocuronium administration through peripheral venous vessels of large diameter. We believe that the clinical drug injection through vessels with large venous diameter with the help of USG may be a non-invasive, simple, and reliable method to reduce pain and withdrawal movements in propofol and rocuronium injections.
Literature
1.
go back to reference Hudson RJ, Henthorn TK. Basic principles of pharmacology in anesthesia practice. In: Cullen BF, Stoelting RK, Barash PG, editors. Clinical Anesthesia. 5th ed. Philadelphia: Lippincot Williams & Wilkins; 2006. p. 246–471. Hudson RJ, Henthorn TK. Basic principles of pharmacology in anesthesia practice. In: Cullen BF, Stoelting RK, Barash PG, editors. Clinical Anesthesia. 5th ed. Philadelphia: Lippincot Williams & Wilkins; 2006. p. 246–471.
2.
go back to reference Yılmaz S, Uğur B, Oğurlu M. Evaluation of pain and hemodynamic variables associated with rocuronium injection. Türkiye Klinikleri J Anesthesiol Reanim. 2012;10:21–7. Yılmaz S, Uğur B, Oğurlu M. Evaluation of pain and hemodynamic variables associated with rocuronium injection. Türkiye Klinikleri J Anesthesiol Reanim. 2012;10:21–7.
3.
go back to reference McCrirrick A, Hunter S. Pain on injection of propofol: the effect of injectate temperature. Anaesthesia. 1990;45:443–4.CrossRefPubMed McCrirrick A, Hunter S. Pain on injection of propofol: the effect of injectate temperature. Anaesthesia. 1990;45:443–4.CrossRefPubMed
4.
go back to reference Borgeat A, Kwiatkowski D. Spontaneous movements associated with rocuronium: is pain on injection the cause? Br J Anaesth. 1997;79:382–3.CrossRefPubMed Borgeat A, Kwiatkowski D. Spontaneous movements associated with rocuronium: is pain on injection the cause? Br J Anaesth. 1997;79:382–3.CrossRefPubMed
6.
go back to reference Steegers MA, Robertson EN. Pain on injection of rocuronium bromide. Anesth Analg. 1996;83:193–205.CrossRef Steegers MA, Robertson EN. Pain on injection of rocuronium bromide. Anesth Analg. 1996;83:193–205.CrossRef
7.
8.
go back to reference Cheong KF, Wong WH. Pain on injection of rocuronium: influence of two doses of lidocaine pretreatment. Br J Anaesth. 2000;84:106–7.CrossRefPubMed Cheong KF, Wong WH. Pain on injection of rocuronium: influence of two doses of lidocaine pretreatment. Br J Anaesth. 2000;84:106–7.CrossRefPubMed
9.
go back to reference Nathanson MH, Gajraj NM, Russell JA. Prevention of pain on injection of propofol: a comparison of lidocaine with alfentanil. Anesth Analg. 1996;82:469–71.PubMed Nathanson MH, Gajraj NM, Russell JA. Prevention of pain on injection of propofol: a comparison of lidocaine with alfentanil. Anesth Analg. 1996;82:469–71.PubMed
11.
go back to reference Scott RP. Saunders DA., Norman J: propofol: clinical strategies for preventing the pain of injection. Anaesthesia. 1988;43:492–4.CrossRefPubMed Scott RP. Saunders DA., Norman J: propofol: clinical strategies for preventing the pain of injection. Anaesthesia. 1988;43:492–4.CrossRefPubMed
12.
go back to reference Tariq MA, Kamran M. Incidence of pain on propofol injection and efficacy of addition of lignocaine or selecting big vein or both combined in reducing it: a randomized control trial. J Postgrad Med Inst. 2006;20:8–11. Tariq MA, Kamran M. Incidence of pain on propofol injection and efficacy of addition of lignocaine or selecting big vein or both combined in reducing it: a randomized control trial. J Postgrad Med Inst. 2006;20:8–11.
13.
go back to reference Lui JT, Huang SJ, Yang CY, Hsu JC, Lui PW. Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration. Chang Gung Med J. 2002;25:617–20.PubMed Lui JT, Huang SJ, Yang CY, Hsu JC, Lui PW. Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration. Chang Gung Med J. 2002;25:617–20.PubMed
14.
go back to reference Klement W, Arndt JO. Pain on i.v. injection of some anaesthetic agents is evoked by the un physiological osmolality or pH of their formulations. Br J Anaesth. 1991;66(2):189–95.CrossRefPubMed Klement W, Arndt JO. Pain on i.v. injection of some anaesthetic agents is evoked by the un physiological osmolality or pH of their formulations. Br J Anaesth. 1991;66(2):189–95.CrossRefPubMed
15.
go back to reference Tuncali B, Karci A, Tuncali BE, Mavioglu O, Olguner CG, Ayhan S, Elar Z. Dilution of rocuronium to 0.5 mg/mL with 0.9% NaCl eliminates the pain during intravenous injection in awake patients. Anesth Analg. 2004;99:740–3.CrossRefPubMed Tuncali B, Karci A, Tuncali BE, Mavioglu O, Olguner CG, Ayhan S, Elar Z. Dilution of rocuronium to 0.5 mg/mL with 0.9% NaCl eliminates the pain during intravenous injection in awake patients. Anesth Analg. 2004;99:740–3.CrossRefPubMed
16.
go back to reference Borgeat A, Kwiatkowski D, Ruetsch YA. Spontaneous movements associated with rocuronium injection: the effects of prior administration of fentanyl. J Clin Anesth. 1997;9:650–2.CrossRefPubMed Borgeat A, Kwiatkowski D, Ruetsch YA. Spontaneous movements associated with rocuronium injection: the effects of prior administration of fentanyl. J Clin Anesth. 1997;9:650–2.CrossRefPubMed
17.
18.
go back to reference Blunk JA, Seifert F, Schmelz M, Reeh PW, Koppert W. Injection pain of rocuronium and vecuronium is evoked by direct activation of nociceptive nerve endings. Eur J Anaesthesiol. 2003;20:245–53.CrossRefPubMed Blunk JA, Seifert F, Schmelz M, Reeh PW, Koppert W. Injection pain of rocuronium and vecuronium is evoked by direct activation of nociceptive nerve endings. Eur J Anaesthesiol. 2003;20:245–53.CrossRefPubMed
19.
go back to reference Baek SH, Woo CM, Lee HJ, Yoon JY, Kwon JY, Shin SW. Rocuronium-induced withdrawal movements associated with different rocuronium injection method. Paediatr Anaesth. 2008;18:515–9.CrossRefPubMed Baek SH, Woo CM, Lee HJ, Yoon JY, Kwon JY, Shin SW. Rocuronium-induced withdrawal movements associated with different rocuronium injection method. Paediatr Anaesth. 2008;18:515–9.CrossRefPubMed
20.
go back to reference Chiarella AB, Jolly DT, Huston CM, Clanachan AS. Comparison of four strategies to reduce the pain as sociated with intravenous administration of rocuronium. Br J Anaesth. 2003;90:377–9.CrossRefPubMed Chiarella AB, Jolly DT, Huston CM, Clanachan AS. Comparison of four strategies to reduce the pain as sociated with intravenous administration of rocuronium. Br J Anaesth. 2003;90:377–9.CrossRefPubMed
22.
go back to reference Clinical pharmacology. In: John F. Butterworth IV, David C. Mackey, John D. Wasnick, editors. Morgan & Mikhail’s Clinical Anesthesiology 5th ed. Los Angeles: Appleton&Lange; 2013. p.143-277. Clinical pharmacology. In: John F. Butterworth IV, David C. Mackey, John D. Wasnick, editors. Morgan & Mikhail’s Clinical Anesthesiology 5th ed. Los Angeles: Appleton&Lange; 2013. p.143-277.
23.
go back to reference Lee YC, Jang YH, Kim JM, Lee SG. Rapid injection of rocuronium reduces withdrawal movement on injection. J Clin Anesth. 2009;21:427–30.CrossRefPubMed Lee YC, Jang YH, Kim JM, Lee SG. Rapid injection of rocuronium reduces withdrawal movement on injection. J Clin Anesth. 2009;21:427–30.CrossRefPubMed
24.
go back to reference Shin YH, Kim CS, Lee JH, Sim WS, Ko JS, Cho HS, Jeong HY, Lee HW, Kim SH. Dilution and slow injection reduces the incidence of rocuronium-induced withdrawal movements in children. Korean J Anesthesiol. 2011;61:465–9.CrossRefPubMedPubMedCentral Shin YH, Kim CS, Lee JH, Sim WS, Ko JS, Cho HS, Jeong HY, Lee HW, Kim SH. Dilution and slow injection reduces the incidence of rocuronium-induced withdrawal movements in children. Korean J Anesthesiol. 2011;61:465–9.CrossRefPubMedPubMedCentral
25.
go back to reference Akkaya T, Toygar P, Bedirli N, Yazıcıoğlu D, Gümüş H. Effects of pretreatment with lidoca -ine or ketamine on ınjection pain and with drawal movements of rocuronium. Turk J Med Sci. 2008;38:577–82. Akkaya T, Toygar P, Bedirli N, Yazıcıoğlu D, Gümüş H. Effects of pretreatment with lidoca -ine or ketamine on ınjection pain and with drawal movements of rocuronium. Turk J Med Sci. 2008;38:577–82.
Metadata
Title
The evaluation of the effect of venous diameter measurement by ultrasonography on pain and withdrawal response
Authors
Sinan Yılmaz
Yasemin Hatiboğlu
Publication date
01-06-2018
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 3/2018
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-018-2489-5

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