Lidocaine Versus Ketamine Pretreatment on Propofol Injection Pain

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Amir Murad Khudadad Boujan Nashmeel fazeel Kareem Amanj A. Marouf Saman Abdullah Ahmed Fahmi Salah Qadir Mahmood

Abstract

Propofol is commonly used intravenous anesthesia induction drug but it causes ache upon use, many methods with different results, have been suggested to prevent this pain, the current research was concluded in order to investigate the impact of lidocaine, ketamine in reducing the ache on giving intravenous propofol. This study is randomized controlled clinical trial lasting from June 2015 to November 2015 during which 107 consenting (ASA1 and ASA2) patients were prepared for elective operation with general anesthesia. They randomly split to three subgroups, A cannula (size20) used   in the dorsum hand veins, standard monitor was established patients received either 2mL (40 mg) of lidocaine or 2mL (20mg) of ketamine and 2 mL of saline 1 min before injection   2.5 milligram per kilogram propofol.  ache severity observed by using four number pain scale, zero = none, one= mild pain, two = moderate pain, and three = intense pain. Atracurium used for indotracheal intubation, isoflurane and fentanyl for anesthesia maintenance. There were no variations between the study groups regarding ASA status, Sex, age. The incidence of ache when injecting propofol were observed in the normal saline group was 86.5% and it was more than ketamine group 0% and lidocaine group 20% (p=0.0002). In the normal saline pretreatment group 8.1% of the patient experienced severe pain, compared with   0% in the lidocaine and ketamine. It can be concluded that intravenous ketamine and lidocaine were equally effective in preventing Ache during propofol injection.  

Keywords

propofol, pain, lidocaine, Ketamine.

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References

[1] D. Singh, S. Jagannath, S.Priye "Prevention of propofol injection pain: Comparison between lidocaine and ramosetron" Journal of Anaesthesiology and Clinical Pharmacol, 30 (2) pp. 213–216, 2014.
[2] J. Butterworth. David Mackey. John Wasnick. Morgan and Mikhails Clinical Anesthesiology, McGraw-Hill Education, 2013.
[3] C. H. Tan and M. K. Onsiong. "Pain on injection of propofol" journal of Anaesthesia, 53(5) pp.468-476, 1998.
[4] E. Liljeroth, Pain induced by propofol, Lund university medical faculty, doctoral dissertation series, 2007.
[5] S Ray, R Pal, S Pal, J Kirtania, D Sarbapalli, "Preclusion of pain on injection with propofol: Evaluating the effects of lignocaine or fentanyl pretreatment" Anesth Essays Res 5 pp.33-38, 2011.
[6] M Nakane , H Iwama. "Potential mechanism of propofol-induced pain on injection based on studies using nafamostat mesilate" British journal of anesthesia, 38(3) pp. 397-404, 1999.
[7] T.N. Calvey and N.E. Williams, Principles and practice of pharmacology for anesthetists, Wiley on line library, 2008.
[8] A. R. Aitkenhead, G. David, J. Rowbotham, text book of anesthesia, Churchill Livingstone, Elsevier, 2007.
[9] M Gupta, S Mishra, D Gupta, M Gujjar, "Prevention of Pain on Propofol Injection: A Comparative, Randomized, Double Blind Study between Lignocaine, Pethidine, Dexamethasone and Placebo" The Internet Journal of Anesthesiology, 11 (2) 2006.
[10] H. Zahedi, M. Nikooseresht. "Prevention of propofol injection pain with small dose ketamine" M.E.J.ANESTH, 20 (3) pp.401-404, 2009.
[11] R. Polat, M. Aktay, O. Özlü. "The effects of remifentanil, lidocaine, metoclopramide, or ketamine pretreatment on propofol injection pain" M.E.J. ANESTH, 21 (5) pp. 673-677, 2012.
[12] I Saadawy, E Ertok, A Boker. "Painless injection of propofol: pretreatment with ketamine vs thiopental, meperidine, and lidocaine" Middle East J Anesthesiol, 19 (3) pp.631-44, 2007.
[13] S. Koo, S. Cho, Y. Kim, "Small-Dose Ketamine Reduces the Pain of Propofol Injection"Anesth Analg, 103, pp.1444-1447, 2006.
[14] F Bano , S Zafar , S Sabbar , S Aftab , S. Haider. ".Intravenous ketamine attenuates injection pain and arterial pressure changes during the induction of anesthesia with propofol: a comparison with lidocaine" Journal of the College of Physicians and Surgeons--Pakistan , 17(7) pp.390-393, 2007.
[15] V. Ayatollahi, S. Behdad , S. Kargar , "Comparison of Effects of Ephedrine, Lidocaine and Ketamine with Placebo on Injection Pain, Hypotension and Bradycardia Due to Propofol Injection: A Randomized Placebo Controlled Clinical Trial " Acta Medica Iranica, 50(9) pp.609-614, 2012
[16] L. Jalota, V. Kalira, E. George. "Prevention of pain on injection of propofol: systematic review and meta-analysis" BMJ, pp.342, 2011.
[17] MH Nathanson, NM Gajraj, JA Russell. "Prevention of pain on injection of propofol: A comparison of lidocaine with alfentanil" Anesth Analg, 82 pp.469-71, 1996.
[18] WW Pang, PY Huang, DP Chang, MH Huang. "The peripheral analgesic effect of Tramadol in reducing propofol injection pain: a comparison with lidocaine" Reg Anesth Pain Med, 24 (3) pp.246-9, 1999.
[19] SY King, FM Davis, JE Wells, DJ Murchinson, PJ Pryor. "Lidocaine for the prevention of pain due to injection of propofol" Anesthesia and Analgesia, 74(2) pp. 246-249, 1992.
[20] M. Alipour, Masoomeh Tabari, and Masoomeh Alipour "Paracetamol, Ondasteron, Granisetron, Magnesium Sulfate and Lidocaine and Reduced Propofol Injection Pain" Iran Red Crescent Med, 16(3) 2014.
[21] N Kad, P Malik, J Dureja, A Thakur. "Ketamine pretreatment to alleviate the pain of propofol injection" The Internet Journal of Anesthesiology, 20 (2) pp.1-5, 2008.
[22] S Suzuki, T Masamune, A Nonaka. " Pretreatment with ketamine reduces incidence and severity of pain on propofol injection" Masui, 51(2) pp.140-143, 2002.
[23] CH Tan, MK Onsiong, SW Kua. "The effect of ketamine pretreatment on propofol injection pain in 100 women" Anesthesia, 53(3) pp.302-305, 1998.
[24] SW Hong, KH Kwak. "The Effects of Different Doses of Remifentanil on Propofol Injection Pain: A Placebo Controlled Comparison of Ketamine" Korean J Anesthesiol, 51(3) pp.302-307, 2006.