Zekeriyya ALANOĞLU, ALİ ABBAS YILMAZ, Dilara YILMAZ, Evren EKER, İbrahim AŞIK, Neslihan ALKIŞ

Rokuronyum enjeksiyon ağrısını önlemede lidokain veya tramadol kullanımının karşılaştırılması

Amaç: Rokuronyumun intravenöz uygulaması sıklıkla uygulandığı yerde ağrıya neden olmaktadır. Bu kontrollü, randomize çalışma rokuronyumun neden olduğu ağrı insidansını belirlemek ve bu ağrıyı gidermek için lidokain veya tramadol kullanımının etkisini karşılaştırmayı amaçlamaktadır. Yöntem: 90 hasta uygulama öncesi ilaç olarak tramadol 40 mg (n=30), lidokain 40 mg (n=30) veya plasebo (n=30) olacak şekilde kapalı zarf yöntemi ile üç gruba ayrıldı. Ön kola uygulanan turnike ile venöz dönüş engellendikten sonra seçilen çalışma ilacı enjekte edildi. 30 saniye sonra turnike indirilerek %1 rokuronyum (0.6 mg kg'1) 5 saniye içinde enjekte edildi. Hemen ardından hastaya ağrısının olup olmadığı, yeri ve karakteri soruldu. Bulgular: Ağrı insidansı plasebo grubunda (NaCl %0.9) %80 iken lidokain veya tramadol uygulanan gruplarda benzer şekilde %17 ve %17'ye geriledi (p

Anahtar Kelimeler:

Enjeksiyon, ven içi, Ağrı, Tramadol, Lidokain

A comparison of the use of lidocaine or tramadol for the prevention of pain during rocuronium injection

Objective: Intravenous injection of rocuronium is commonly associated with pain at the injection site. This randomized, controlled study was designed to examine the incidence of pain on injection of rocuronium and to compare the efficacy of lidocaine or tramadol for its prevention. Method: Ninety patients were randomly assigned to one of three groups to receive either tramadol (T) 40 mg (n=30), lidocaine (L) 40 mg (n=30) or placebo (P) (n=30) as a pre-treatment drug. Following venous occlusion with cuffed tourniquet, study drug was injected, and tourniquet was maintained for 30 seconds. After tourniquet release, 1% rocuronium 0.6 mg kg1 was administered immediately in 5 seconds. Immediately after the injection of rocuronium, patients were questioned about the presence, localization and intensity of the pain. Results: The incidence of pain was 80% in Group P and was significantly decreased to 17% and 17% in Group L and Group T, respectively (p<0.001). The incidence of hand and wrist movement was higher in Group P than Group T and L (p<0.05). The number of patients in group P (n=8) who exhibited movement involving forearm with rocuronium injection was higher compared to GroupT(n=2)andL(n=l)(p<0.01) Conclusion: The results of this study suggest that pain associated with administration of rocuronium can be attenuated significantly by pre-treatment with either lidocaine or tramadol intravenously. However, the effects of lidocaine and tramadol were similar.

Keywords:

Injections, Intravenous, Pain, Tramadol, Lidocaine,

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