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Pain on injection of propofol: comparison of metoprolol with lidocaine

Published online by Cambridge University Press:  11 July 2005

İ Aşık ,
D. Yörükoğlu ,
I. Gülay  and
M. Tulunay
İ Aşık
Affiliation:
University of Ankara, Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Ankara, Turkey
D. Yörükoğlu
Affiliation:
University of Ankara, Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Ankara, Turkey
I. Gülay
Affiliation:
University of Ankara, Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Ankara, Turkey
M. Tulunay
Affiliation:
University of Ankara, Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Ankara, Turkey
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Extract

Summary

Background and objective: Pain is often experienced when propofol is injected, and intravenous lidocaine is often effective in preventing such pain. We decided to determine whether metoprolol, given before the injection of propofol, is as effective as lidocaine in reducing the incidence and severity of the pain.

Methods: Ninety patients scheduled for elective surgery under general anaesthesia were randomly allocated to one of three groups to receive either metoprolol 2 mg, lidocaine 20 mg or saline 2 mL before any propofol was injected. Each patient was given one of these agents intravenously via a 20-G cannula on the dorsum of the hand whilst the venous drainage was occluded manually, at the middle of the forearm, for 45 s. After the occlusion was released, propofol 2.0–2.5 mg kg−1, at room temperature, was injected at 2 mL (20 mg) every 4 s. Pain was assessed verbally and scored as none (0), mild (1) or severe (2).

Results: The incidence of severe pain in the control group (56.7%) was significantly higher than in the metoprolol and lidocaine groups (16.6 and 10%, respectively). The number of patients who were free of pain was significantly higher in those who had been given either metoprolol or lidocaine.

Conclusions: Pretreatment with intravenous metoprolol was equally as effective as lidocaine in reducing the pain associated with propofol injection.

Keywords

ANAESTHETICSpropofol, ADRENERGIC ANTAGONISTS, adrenergic β-antagonists, metoprololCOMPLICATIONSSENSATION, pain
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 6 , June 2003 , pp. 487 - 489
Copyright
© 2003 European Society of Anaesthesiology

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References

Mangar D, Holak EJ. Tourniquet at 50 mmHg followed by intravenous lidocaine diminishes hand pain associated with propofol injection. Anesth Analg 1992; 74: 250–252.Google Scholar
Stark RD, Binks SM, Dutka VN, et al. A review of the safety and tolerance of propofol. Postgrad Med J 1985; 61 (Suppl 3): 152–156.Google Scholar
Ganta R, Fee JP. Pain on injection of propofol: comparison of lignocaine with metoclopramide. Br J Anaesth 1992; 69: 316–317.Google Scholar
Brooker J, Hull CJ, Stafford M. Effect of lignocaine on pain caused by propofol injection. Anaesthesia 1985; 40: 91–92.Google Scholar
Helbo-Hansen S, Westergaard V, Krogh BL, Svendsen HP. The reduction of pain on injection of propofol: the effect of the addition of lignocaine. Acta Anaesth Scand 1988; 32: 502–504.Google Scholar
Hoffman BB, Lefkowitz RJ. Catecholamines, sympathomimetic drugs and adrenergic receptor antagonists. In: Hardman JG, Limbird LE, Molinoff PB, Ruddon RW, Gilman AE, eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9 edn. New York, USA: McGraw-Hill, 1996: 199–249.
Nicol ME, Moriarty J, Edwards J, Robbie DS, A'Hern RP. Modification of pain on injection of propofol – a comparison between lignocaine and procaine. Anaesthesia 1991; 46: 67–69.Google Scholar
Briggs LP, Clarke RSJ, Dundee JW, et al. Use of di-isopropyl phenol as main agent for short procedures. Br J Anaesth 1981; 53: 1197–1201.Google Scholar
Scott RPF, Saunders DA, Norman J. Propofol: clinical strategies for preventing pain on injection. Anaesthesia 1988; 43: 492–494.Google Scholar
McCulloch MJ, Lees NW. Assessment and modification of pain on induction with propofol (Diprivan). Anaesthesia 1985; 40: 1117–1120.Google Scholar
Klement W, Arndt JO. Pain on injection of propofol: effects of concentration and diluent. Br J Anaesth 1991; 67: 281–284.Google Scholar
McDonald DS, Jameson P. Injection pain with propofol. Reduction with aspiration of blood. Anaesthesia 1996; 51: 878–880.Google Scholar
Huang CL, Wang YP, Cheng YJ, Susetio L, Liu CC. The effect of carrier intravenous fluid speed on the injection of pain of propofol. Anesth Analg 1995; 81: 1087–1088.Google Scholar
McCrirrick A, Hunter S. Pain on injection of propofol: the effect of injectate temperature. Anaesthesia 1990; 45: 443–444.Google Scholar
Fletcher GC, Gillespie JA, Davidson JA. The effect of temperature upon pain during injection of propofol. Anaesthesia 1996; 51: 498–499.Google Scholar
Lomax D. Propofol injection pain. Anaesth Inten Care 1994; 22: 500–501.Google Scholar
Eriksson M. Prilocaine reduces injection pain caused by propofol. Acta Anaesth Scand 1995; 39: 210–213.Google Scholar
Nathanson MH, Gajraj NM, Russel JA. Prevention of pain on injection of propofol: a comparison of lignocaine with alfentanil. Anesth Analg 1996; 82: 469–471.Google Scholar
Helmers JH, Kraaijenhagen RJ, Leeuwen LV, Zuurmond WW. Reduction of pain on injection caused by propofol. Can J Anaesth 1990; 37: 267–268.Google Scholar
King SY, Davis FM, Wells JE, Murchison DJ, Pryor PJ. Lidocaine for the prevention of pain due to injection of propofol. Anesth Analg 1992; 74: 246–249.Google Scholar
Parmar AK, Koay CK. Pain on injection of propofol. A comparison of cold propofol with propofol premixed with lignocaine. Anaesthesia 1998; 53: 79–88.Google Scholar