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Effect of nitrous oxide inhalation on pain after propofol and rocuronium injection

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Abstract

Purpose

This prospective, double-blind, placebo-controlled study was designed to determine the efficacy of nitrous oxide (N2O) in alleviating the pain that followed sequential injection of propofol and rocuronium.

Methods

A total of 205 adult patients (age, 18–68 years) received one of the following combinations: NaCl and 100 % O2 (group C); 0.5 mg/kg lidocaine and 100 % O2 (group L); NaCl and a mixture of 67 % N2O/O2 (group N); or 0.5 mg/kg lidocaine and a mixture of 67 % N2O/O2 (group LN). Vein occlusion was released after 1 min, and 5 ml propofol was injected over 10 s. Pain was evaluated on a visually enlarged, laminated, numeric rating (0–10) scale. The remainder of the induction dose of propofol (with a 3-ml bolus of normal saline and 0.6 mg/kg rocuronium) was then injected. The response to the rocuronium injection was assessed with a four-point scale (0–3).

Results

The incidence and severity of pain from the propofol injection in groups L, N, and LN were significantly lower than those in group C (P < 0.001). Frequency and intensity of the withdrawal response were significantly less in groups N and LN than in groups C and L (no response, P < 0.001; severe response, P < 0.001).

Conclusions

Pretreatment with inhaled N2O can reduce the pain associated with propofol and rocuronium injection. Moreover, N2O (with or without lidocaine) is more effective than lidocaine alone in reducing rocuronium-related withdrawal reactions associated with sequential injection of propofol and rocuronium.

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Author information

Authors and Affiliations

  1. Department of Anesthesia and Pain Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea

    Eunsoo Kim & Do Won Lee

  2. Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 626-870, Korea

    Hae Kyu Kim & Jae Young Kwon

  3. Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 626-870, Korea

    Hee Young Kim

  4. Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 626-870, Korea

    Cheul Hong Kim

Authors
  1. Eunsoo Kim
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  2. Cheul Hong Kim
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  3. Hae Kyu Kim
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Correspondence to Cheul Hong Kim.

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Kim, E., Kim, C.H., Kim, H.K. et al. Effect of nitrous oxide inhalation on pain after propofol and rocuronium injection. J Anesth 27, 868–873 (2013). https://doi.org/10.1007/s00540-013-1655-z

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  • DOI: https://doi.org/10.1007/s00540-013-1655-z

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