Archives of Anesthesiology and Critical Care 2017. 3(4):382-384.

A Comparison of Premedication Injections of Magnesium Sulfate, Ketamine and Lidocaine on the severity of Pain Induced by Intravenous Injection of Propofol
Masoum Khoshfetrat, Faranak Beirami, Forogh Safar Panah, Aliakbar keykha

Abstract


Background: The pain induced by intravenous injection of propofol is controlled using a variety of methods, but there is no consensus in choosing the best effective method. Therefore, this study was conducted to compare premedication injections of magnesium sulfate, ketamine and lidocaine on pain induced by intravenous injection of propofol.

Methods: The present double-blind clinical trial was conducted on 150 patients with elective orthopedic surgery under general anesthesia. The patients were randomly assigned into three groups of 50; Group I: 2 cc magnesium sulfate 20%, Group II: 2 cc Ketamine at a dose of 0.1mg/kg and Group III: 2 cc lidocaine 2% at a dose of 0.05mg/kg. One minute after injecting the drugs, 2mg/kg intravenous propofol was injected in all groups and then a trained unaware expert evaluated the severity of subsequent pain using a Numeric Pain Rating Scale.

Results: The mean age of the patients was 39.3±12.3 years, and the mean weight was 67.4±11.5 kg. The patients consisted of 98 (65.4%) males and 52 (34.6%) females. Ten in the Group magnesium sulfate, eight in the Group ketamine and seven in the Group lidocaine complained of pain. The mean pain severity was 0.85±0.38 in the Group magnesium sulfate, 0.66±0.26 in the Group ketamine and 0.62±0.22 in the Group lidocaine (P=0.513).

Conclusion: The Group lidocaine showed further pain relief compared to other two groups, but there was no statistically significant difference.


Keywords


ketamine; lidocaine; magnesium sulfate; pain induced by injection of propofol

Full Text:

PDF

References


Kariman Majed M, Emadi S, Nasiri E, Farzin D. Comparison of the effects of different doses of ketamine propofol on haemodynamic changes of the patients during induction of anesthesia. Journal of Mazandaran University of Medical Sciences. 2006; 16(54):7-13.

Tan C, Onsiong M. Pain on injection of propofol. Anaesthesia. 1998; 53(5):468-76.

He L, Xu J-M, He T, Liu L, Zhu R. Dexmedetomidine pretreatment alleviates propofol injection pain. Ups J Med Sci. 2014; 119(4):338-42.

Kwak K-H, Ha J, Kim Y, Jeon Y. Efficacy of combination intravenous lidocaine and dexamethasone on propofol injection pain: a randomized, double-blind, prospective study in adult Korean surgical patients. Clin Ther. 2008; 30(6):1113-9.

Jeon Y. Reduction of pain on injection of propofol: combination of nitroglycerin and lidocaine. J Anesth. 2012; 26(5):728-31.

Morishima T, Sobue K, Arima H, Tanaka S, So M, Ando H, et al. Profound pain due to propofol injection triggered myocardial ischemia in a patient with a suspected pheochromocytoma. Anesth Analg. 2003; 96(2):631.

Picard P, Tramèr MR. Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg. 2000; 90(4):963-9.

Yamakage M, Iwasaki S, Satoh J-I, Namiki A. Changes in concentrations of free propofol by modification of the solution. Anesth Analg. 2005; 101(2):385-8.

Fujii Y, Nakayama M. Prevention of pain due to injection of propofol with IV administration of lidocaine 40 mg+ metoclopramide 2.5, 5, or 10 mg or saline: a randomized, double-blind study in Japanese adult surgical patients. Clin Ther. 2007; 29(5):856-61.

Ghai B, Makkar JK, Bala I, Wig J. Effect of parecoxib pretreatment and venous occlusion on propofol injection pain: a prospective, randomized, double-blinded, placebo-controlled study. J Clin Anesth. 2010; 22(2):88-92.

Agarwal A, Raza M, Dhiraaj S, Pandey R, Gupta D, Pandey CK, et al. Pain during injection of propofol: the effect of prior administration of butorphanol. Anesth Analg. 2004; 99(1):117-9.

Kim DH, Chae YJ, Chang HS, Kim JA, Joe HB. Intravenous lidocaine pretreatment with venous occlusion for reducing microemulsion propofol induced pain: Comparison of three doses of lidocaine. J Int Med Res. 2014; 42(2):368-75.

Jeong M, Yoon H. Comparison of the effects of lidocaine pre-administration and local warming of the intravenous access site on propofol injection pain: Randomized, double-blind controlled trial. Int J Nurs Stud. 2016; 61:209-18.

Chaudhary K, Gupta P, Gogia AR. A prospective, randomized, double-blind study to compare the efficacy of lidocaine+ metoclopramide and lidocaine+ ketamine combinations in preventing pain on propofol injection. J Anesth. 2013; 27(3):402-6.

Sun J, Zhou R, Lin W, Zhou J, Wang W. Magnesium Sulfate Plus Lidocaine Reduces Propofol Injection Pain: A Double-blind, Randomized Study. Clin Ther. 2016; 38(1):31-8.

Salman EA, Titiz L, Akpek E, Arslan G. Pretreatment with a very low dose of intravenous esmolol reduces propofol injection pain. Agri. 2013; 25(1):8-13.

Boku A, Inoue M, Hanamoto H, Oyamaguchi A, Kudo C, Sugimura M, et al. Effective dosage of midazolam to erase the memory of vascular pain during propofol administration. Anesth Prog. 2016; 63(3):147-55.

Wang W, Zhou L, Wu L-X, Wang T, Zhang C-B, Sun L. 5-HT3 receptor antagonists for propofol injection pain: A meta-analysis of randomized controlled trials. Clin Drug Investig. 2016; 36(4):243-53.

Afhami M, Naghipour B, Hassanzadeh Salmasi P. Effect of Ephedrine on Reducing Pain Induced by Intravenous Injection of Propofol at the Time of Anesthesia Induction. Armaghane danesh. 2006; 10(4):1-11.

Özkoçak I, Altunkaya H, Özer Y, Ayoğlu H, Demırel C, Çıçek E. Comparison of ephedrine and ketamine in prevention of injection pain and hypotension due to propofol induction. Eur J Anaesthesiol. 2005; 22(1):44-8.

Alizadeh V, Kazemihaki B, Eftekhari J, Tizro P. Comparison of pain on propofol injection with three methods: mixed lidocaine with Propofol, propofol after lidocaine injection and purified one percent propofol injection. Anesthesiology and Pain. 2015; 4(3):30-7.

Safavi M, Honarmand A. Magnesium sulfate pretreatment to alleviate pain on propofol injection: a comparison with ketamine or lidocaine. Journal of Mazandaran University of Medical Sciences. 2007; 17(60):30-8.

Koo S-W, Cho S-J, Kim Y-K, Ham K-D, Hwang J-H. Small-dose ketamine reduces the pain of propofol injection. Anesth Analg. 2006; 103(6):1444-7.

Canbay O, Celebi N, Arun O, Karagöz A, Sarıcaoğlu F, Özgen S. Efficacy of intravenous acetaminophen and lidocaine on propofol injection pain. Br J Anaesth. 2008; 100(1):95-8.

Mohammadzadeh A, Haghighi M, Amir-alavi S, Naderi-nabi B, Nekoofard M, Abad M. A Comparison of Effects of Alfentanil, Magnesium Sulfate and Ketamin on Reduction the Pain during Propofol Injection. Anesthesiology and Pain. 2011; 2(5):52-8.


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.