PMID- 24648574
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140320
LR  - 20211022
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 72
IP  - 1
DP  - 2011 Feb
TI  - Novel Use of Hydromorphone as a Pretreatment Agent: A Double-blind, Randomized, 
      Controlled Study in Adult Korean Surgical Patients.
PG  - 36-48
LID - 10.1016/j.curtheres.2011.02.001 [doi]
AB  - BACKGROUND: Hydromorphone is a potent mu-opioid selective agonist that has an 
      onset time within 5 minutes and reaches peak effect between 10 and 20 minutes. 
      However, it may show immediate analgesic effect to rocuronium-induced pain 
      because of its peripheral analgesic property and also may attenuate noxious 
      stimuli from tracheal intubation during induction. The opioid receptors are known 
      to be present in peripheral sensory nerve terminals as well as in the dorsal root 
      ganglion and the central terminal of primary afferent nerves. Therefore, we 
      hypothesized that hydromorphone may be considered a potent pretreatment or 
      adjuvant drug during the induction of anesthesia with its peripherally and 
      centrally mediated analgesia. OBJECTIVE: The aim of this study was to compare the 
      effects of pretreatment with hydromorphone in reducing rocuronium-induced 
      withdrawal movements and hemodynamic changes during tracheal intubation with the 
      effects of fentanyl and normal saline. METHODS: In this double-blind, randomized, 
      controlled study, consecutive adult patients aged 20 to 70 years who were 
      scheduled to undergo general anesthesia for elective gastric or colorectal 
      surgery at the Samsung Seoul Hospital (Seoul, Republic of Korea) were randomly 
      assigned to receive 5 mL hydromorphone 0.03 mg/kg or fentanyl 2 mug/kg or normal 
      saline. Thirty seconds after administering the study drug, anesthesia was induced 
      with 2.5% thiopental sodium 5 mg/kg. After loss of consciousness, rocuronium 0.6 
      mg/kg was injected and immediate withdrawal movements were recorded. Two minutes 
      after rocuronium injection, tracheal intubation was performed and hemodynamic 
      changes were observed. RESULTS: A total of 194 patients were enrolled, with 65 in 
      the hydromorphone group, 67 in the fentanyl group, and 62 in the saline group. 
      The overall incidence of withdrawal movements was significantly lower in the 
      hydromorphone group (2 patients; 3.1%) and the fentanyl group (5 patients; 7.5%) 
      (both, P < 0.001) than in the saline group (36 patients; 58.1%). The mean 
      arterial pressure (MAP) and heart rate (HR) after intubation (median 
      [interquartile range]) in the fentanyl group (101.5 [84-115] mm Hg; 93.5 [82-102] 
      beats per minute [bpm]) and the hydromorphone group (93.0 [83-106] mm Hg; 90.0 
      [86.3-93.6] bpm) were significantly lower than these measures in the saline group 
      (111.5 [105-123] mm Hg; 103.5 [96-113] bpm) (fentanyl group MAP and HR, P < 
      0.001; hydromorphone group MAP and HR, P < 0.001). CONCLUSIONS: Pretreatment with 
      hydromorphone and fentanyl may have similar effectiveness in reducing withdrawal 
      movements in response to rocuronium injection pain and inducing immediate general 
      anesthesia.
FAU - Lee, Sang Hyun
AU  - Lee SH
AD  - Department of Anesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung 
      Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of 
      Korea.
FAU - Lee, Chul Joong
AU  - Lee CJ
AD  - Department of Anesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung 
      Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of 
      Korea.
FAU - Kim, Tae Hyeong
AU  - Kim TH
AD  - Department of Anesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung 
      Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of 
      Korea.
FAU - Shin, Byung Seop
AU  - Shin BS
AD  - Department of Anesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung 
      Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of 
      Korea.
FAU - Lee, Suk Young
AU  - Lee SY
AD  - Department of Anesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung 
      Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of 
      Korea.
FAU - Joo, Eun Young
AU  - Joo EY
AD  - Department of Anesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung 
      Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of 
      Korea.
FAU - Sim, Woo Seog
AU  - Sim WS
AD  - Department of Anesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung 
      Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of 
      Korea.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3955243
OTO - NOTNLM
OT  - hydromorphone
OT  - induction of anesthesia
OT  - injection pain
OT  - rocuronium
OT  - withdrawal movement
EDAT- 2011/02/01 00:00
MHDA- 2011/02/01 00:01
PMCR- 2011/02/01
CRDT- 2014/03/21 06:00
PHST- 2011/02/07 00:00 [accepted]
PHST- 2014/03/21 06:00 [entrez]
PHST- 2011/02/01 00:00 [pubmed]
PHST- 2011/02/01 00:01 [medline]
PHST- 2011/02/01 00:00 [pmc-release]
AID - S0011-393X(11)00002-6 [pii]
AID - 10.1016/j.curtheres.2011.02.001 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2011 Feb;72(1):36-48. doi: 
      10.1016/j.curtheres.2011.02.001.