A comparison of tramadol, sufentanil, meperidine, and lidocaine in prevention of pain due to rocuronium injection

Aim: Alleviation of the pain resulting from injection of rocuronium during anesthesia is still an unsolved problem. We aimed to compare the analgesic effects of sufentanil, tramadol, meperidine, and lidocaine on the pain from injection of rocuronium.Materials and methods: This prospective randomized double-blind study included 200 patients with ASA I–II. After a tourniquet was applied to the forearm, patients received 50 mg of tramadol (group T), 10 µg of sufentanil (group S), 40 mg of meperidine (group M), or 30 mg of lidocaine (group L). The tourniquet was released after 20 s and rocuronium was injected over 10 to 15 s. The patients were asked whether the injection caused pain or not. Side effects were recorded.Results: The incidence of injection pain was highest in group T. Severe pain was most frequently encountered in group S. Lidocaine was the most effective analgesic in alleviating the injection pain while sufentanil was the least effective drug (P 0.05). Erythema was the common side effect at the injection site in group M and arrhythmia was observed in group T.Conclusion: The analgesic effect of meperidine was not significantly superior to that of the other drugs. Lidocaine seemed to be the most effective analgesic drug for minimizing the pain due to rocuronium injection.