Comparison of the effectiveness of pretreatment by fentanyl and remifentanil on rocuronium induced injection pain

Objectives: To compare the efficacy of fentanyl and remifentanil as prodrugs in the prevention of rocuronium injection pain by using a control group. Methods: In a randomized, double-blinded, controlled study, 102 adult patients aged between 18-60 undergoing elective surgery under general anesthesia and classified into American Society of Anesthesiologists (ASA) I and ASA II risk groups were included in the study. The study was carried out from July 2005 to April 2006 at Dokuz Eylül University, Izmir, Turkey. Unpremedicated patients were randomly allocated to one of 3 groups. Patients received 2 mL (0.02 mg) of remifentanil (n =34), 2 mL of fentanyl 0.1 mg (n=34), and 2 mL of saline (n =34), by injection over 10 seconds. Thirty seconds after prodrug administration, 10 mg (10 mg/ mL) intravenous rocuronium bromide was administered over 5 seconds and pain assessment was performed by using a 5-point scale. Results: When the 3 groups of 34 patients were compared in terms of pain assessment scoring, a statistically significant difference was determined (p=0.02). When the groups were paired, it was seen that this difference resulted from the remifentanil and saline groups (p=0.02). Conclusion: This study shows that a bolus dose of 0.02 mg of remifentanil is a more effective prodrug administration compared to the application of saline, however, remifentanil and fentanyl have no superiority over one another and the administration of fentanyl is equally effective as saline prodrug administration.