Generic rocuronium reduces withdrawal movements compared to original rocuronium under target-controlled infusion induction with propofol

J Anesth. 2021 Apr;35(2):184-188. doi: 10.1007/s00540-020-02889-2. Epub 2021 Jan 9.

Abstract

Purpose: Rocuronium-induced injection pain often causes withdrawal movements leading to accidental disruption of indwelling needles. Generic rocuronium (Maruishi Pharmaceutical Co., Ltd, Osaka, Japan) with a novel solution has been reported to reduce the injection pain compared to original rocuronium [Esmeron® (Eslax®), MSD Co. Ltd, Tokyo, Japan], however, no reports have compared the injection pain under sedation with propofol, the most frequently used general anesthetic. This study was carried out to compare the injection pain caused by generic rocuronium and that caused by original rocuronium in patients anesthetized by propofol with a target-controlled infusion system.

Methods: Forty patients were randomly assigned to two groups in this single-center, prospective, randomized, double-blind study. One group was administered generic rocuronium after sedation with propofol with a target-controlled infusion system. The other group was administered original rocuronium after anesthesia with propofol. Patient's withdrawal movements were assessed with the scale. The primary outcome was the total incidence of movement after administration of rocuronium. Secondary outcome was the incidence of moderate or severe movement after administration of rocuronium.

Results: The total incidence of movement after administration of generic rocuronium (11%) was significantly lower than that after the administration of original rocuronium (79%) (p < 0.01). The incidence of moderate or severe movement after administration of generic rocuronium (0%) was significantly lower than that after the administration of original rocuronium (53%) (p < 0.01).

Conclusion: Generic rocuronium was considered more suitable than the original rocuronium for induction of anesthesia by propofol performed with a target-controlled infusion system.

Keywords: Injection pain; Propofol; Rocuronium; Target-controlled infusion; Withdrawal movements.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Androstanols / adverse effects
  • Anesthetics, Intravenous / adverse effects
  • Double-Blind Method
  • Humans
  • Japan
  • Neuromuscular Nondepolarizing Agents* / adverse effects
  • Propofol* / adverse effects
  • Prospective Studies
  • Rocuronium

Substances

  • Androstanols
  • Anesthetics, Intravenous
  • Neuromuscular Nondepolarizing Agents
  • Rocuronium
  • Propofol