Prevention of Pain on Propofol Injection: A Comparative Prospective Randomized, Double Blind Study between Lignocaine, Pethidine, Dexamethasone and Placebo

摘要

Propofol has become the induction agent of choice for many anesthetist , especially when rapid and complete awakening is considered desirable. However, pain on injection of propofol, which has been reported to occur in 28-90% of patients, is a major drawback to its use. Numerous studies has been performed in attempts to alleviate this pain but intravenous lignocaine is most commonly used agent. A comparative, Prospective randomized, double blind study was undertaken to compare the efficacy of three drugs for prevention of pain on propofol injection on induction of anesthesia in total of 100 patients, divided in 4 groups of 25 patients each 20-60 years of ASA class I & II undergoing upper abdominal surgeries wee included in the study group. Patients were allocated randomly in 4 groups to receive one of study drug, pethidine 25 mg (5 ml) (Group 1), lignocaine (1%) 20 mg ( 5 ml) (Group 2) Dexamethasone 4 mg (5ml) (Group 3 ) and normal saline (.9 % ) (Group 4) each diluted to volume of 5 ml and the administrator blinded to the study drug. After the first 25% of propofol given, patients were asked for intensity of pain she experienced. Lignocaine, pethidine and Dexamethasone significantly reduces the pain on propofol injection in comparison to placebo (p 0.001), but there was no significant difference in pain score among groups 1, 2, 3 (p 0.001). There was no significant difference in recall of pain among groups 1, 2, and 3 (p 0.793). Although there was significant difference between placebo group and other three groups (p 0.001).It was concluded that lignocaine, pethidine and Dexamethasone significantly reduces the pain induced by propofol injection pain as compared to placebo but there is no difference in efficacy for prevention of pain among these three groups.