Neuromuscular blocking characteristics of rocuronium bromide mixed with sodium bicarbonate

Bedi Jyoti, Mahotra KK, Mehta Nandita

Intravenous rocuronium produces intense discomfort at the site of injection hence leading to limb movements. Strategies to reduce or prevent pain on injection, along with the effect of adjuvant on the onset and duration of action were studied. 80 ASA physical status I or II patients, aged 18-65 years scheduled to undergo elective surgery with general anesthesia were enrolled for the study. Patients were randomly allocated into two groups to receive either rocuronium with 7.5% sodium bicarbonate or rocuronium with 0.9% isotonic saline. The patient’s response to rocuronium injection was verified through neuromuscular monitoring at the adductor pollicis muscle using train-of-four (TOF) response. The incidence of withdrawal movement after rocuronium administration was significantly lower in the sodium bicarbonate group along with shorter onset time and increased duration of action than the saline group. We concluded that the mixing of sodium bicarbonate with rocuronium reduces the pain on injection, enhances the potency, shortens the onset and prolongs the duration of action.

Rocuronium Pain Withdrawal movement Sodium bicarbonate train-of-four (TOF) and General Anaesthesia.