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성인에서 Lidocaine 의 전처치가 Rocuronium 의 근이완 발현 시간에 미치는 효과
신동선,최세진,이미정,안미정,양신영 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4
The Effect of Lidocaine on the Onset Time of Rocuronium-induced Neuromuscular Blockade in Adults Mi Joung Lee, M.D.^*, Dong Sun Shin, M.D., Mi Jeong Ahn, M.D. ^+ Sin Young Yang, M.D., and Sae Jin Choi, M.D. Department of Anesthesiology, College of Medicine, Chungnam National University, Korea ^*Department of Anesthesiology, College of Medicine, The catholic Univercity of Korea ^↑Department of Anesthesiology, Okchun Sungmo Hospital, Korea Background: Rapid-sequence intubation is a common technique to reduce anesthetic complication. Due to side effects of succinylcholine, nondepolarzing muscle relaxants have been tried. Rocuronium is a new nondepolarizing muscle relaxant with a brief onset of action, but devoid of the adverse reaction associated with succinylcholine. Most local anesthetics decrease neuromuscular transmission and ponten-tiate neuromuscular blocks of muscle relaxants. The purpose of this study was to examine the effect of lidocaline on the onset time of rocuronium-induced neuromuscular blockade in adults. Methods: Fourty five patients, ASA physical status Ⅰ or Ⅱ, were randomly divided into three groups. Anesthetic induction with thiopental 5 mg/kg was made. Succinylcholine (1.0 mg/kg) was administered intravenously in group 1. Rocuronium (0.6 mg/kg) was given in group 2, additional lidocaine (1.0 mg/kg) was given intravenously 1 minute prior to the administration of rocuromium in group 3. Neuromuscular blockade was assessed by train-of-four at the adductor pollicis muscle with supramaximal stimulation of the ulnar nerve (2 Hz, 0.2 msec) every 10 seconds. The condition of intubation, the appearance of arrhythmias, side effects of drugs, and the changes of mean arterial pressure and heart rate were checked and compared in peri-induction periods. Results: The onset time of group 1 (55.1 ?? 14.9 sec) was faster than that of group 2 (137.8 ?? 46.0 sec) and group 3 (139.3 ?? 41.0 sec), but there was no difference between the onset time of group 2 and that of group 3. Intubating conditions were good or excellent in all groups, but group 1 and 3 were better than group 2. There was no difference between the three groups in hemodynamics. More adverse effects were observed in group 1, that of group 2 and 3 were observed in only one case. Conclusions: The authors concluded that licocaine is not effective on the onset time of rocuronium, but improves the intubating condition. Rocuronium is devoid of side effects of succinylcholine, but not a alternative to succinylcholine because its onset time is too slow when compared with succinylcholine. (Korean J Anesthesiol 2001; 41: 407~414)