Skip to main content
Erschienen in: Journal of Anesthesia 3/2018

23.03.2018 | Original Article

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

verfasst von: Sinan Yılmaz, Yasemin Hatiboğlu

Erschienen in: Journal of Anesthesia | Ausgabe 3/2018

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat Joshi GP, Whitten CW. Pain on injection of rocuronium bromide. Anesth Analg. 1997;84:228–36.CrossRefPubMed Joshi GP, Whitten CW. Pain on injection of rocuronium bromide. Anesth Analg. 1997;84:228–36.CrossRefPubMed
8.
Zurück zum Zitat 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.
Zurück zum Zitat 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
10.
11.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Metadaten
Titel
The evaluation of the effect of venous diameter measurement by ultrasonography on pain and withdrawal response
verfasst von
Sinan Yılmaz
Yasemin Hatiboğlu
Publikationsdatum
23.03.2018
Verlag
Springer Japan
Erschienen in
Journal of Anesthesia / Ausgabe 3/2018
Print ISSN: 0913-8668
Elektronische ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-018-2489-5

Weitere Artikel der Ausgabe 3/2018

Journal of Anesthesia 3/2018 Zur Ausgabe

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.