Deksmedetomidin And Fentanyl Attenuate The Propofol Injection Pain
Abstract views: 21 / PDF downloads: 15
Keywords:Intravenous anaesthetics, Propofol, Dexmedetomidine, Complications, Pain, Premedication, Analgesics, Haemodynamic changes
We performed this study to compare the effects of intravenous dexmedetomidine and fentanyl on propofol injection pain. We conducted a prospective, randomized and double blind study of 120 adult unpremedicated patients (18-65 years of age) scheduled to undergo elective surgery under general anesthesia. The patients were allocated randomly into three groups (n= 40): fentanyl (F), dexmedetomidine (D), and Control (C). Ten ml of the study solution was injected over 10 seconds. One minute after the administration of fentanyl (1 µg/ kg) or dexmedetomidine (0,15 µg/ kg) or placebo, propofol 2,5 mg/ kg was infused at a rate of 20 ml/ min. Injection pain was assessed using a four - point verbal rating scale. The incidence of propofol- associated injection pain were 65% (26) for group C, 27% (16) for group F, and 25% (10) for group D. The incidence of pain were less in the fentanyl, and especially in the dexmedetomidine groups than control group (p< 0.05). Severe pain in groups were D<F<C (p< 0.05). Heart rate and the mean arterial blood pressure of the groups F and D were lower than control groups at baseline, 0, 5, 10, 15, 30 minutes (p< 0.05). HR of the group D was lower than that group F at baseline period (p< 0.05). In addition, MAP of the group D was lower than that group F at 10, 15, 30 min (p< 0.05). Premedication of subclinical doses of dexmedetomidine and fentanyl effectively reduced propofol-induced pain and its intensity.
Angst MS, Mackey SC, Zupfer GH. Reduction of propofol injection pain with a double lumen i.v. set. J Clin Anesth. 1197;9:462-6.
Scott RP, Saunders DA, Norman J. Propofol: clinical strategies for preventing the pain of injection. Anaesthesia. 1988;43:492-4.
Doenicke AW, Roizen MF, Rau J. Reducing pain during propofol injection: the role of the solvent. Anesth Analg. 1996;82:472-4.
King SY, Davis FM, Wells JE. Lidocaine for the prevention of pain due to injection of propofol. Anesth Analg. 1992;74:246-9.
Cheong MA, Kim KS, Choi WJ. Ephedrine reduces the pain from propofol injection. Anesth Analg. 2002;95:1293- 6.
Barbi E, Marchetti F, Gerarduzzi T. Pretreatment with intravenous ketamine reduces propofol injection pain. Paediatr Anaesth. 2003;13:764-8.
Fujii Y, Nakayama M. A lidocaine/metoclopramide combination decreases pain on injection of propofol. Can J Anaesth. 2005;52:474-7.
Agarwal A, Ansari MF, Gupta D. Pretreatment with thiopental for prevention of pain associated with propofol injection. Anesth Analg. 2004;98:683-6.
Huang YW, Buerkle H, Lee TH. Effect of pretreatment with ketorolac on propofol injection pain. Acta Anaesthesiol. Scand. 2002;46:1021-4.
Picard P, Tramer MR. Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg. 2000;90:963-9.
Lilley EM, Isert PR, Carasso ML, Kennedy RA. The effect of the addition of lignocaine on propofol emulsion stability. Anaesthesia. 1996;51:815-8.
Pang WW, Mok MS, Huang S, Hwang MH. The analgesic effect of fentanyl, morphine, meperidine, and lidocaine in the peripheral veins: a comparative study. Anesth Analg. 1998;86:382-6.
Kamibayashi T, Maze M. Clinical uses of alpha2 - adrenergic agonists. Anesthesiology. 2000;93:1345-9.
Turan A, Memis D, Kaya G, Karamanlioglu B. The prevention of pain from injection of propofol by dexmedetomidine and comparison with lidocaine. Can J Anaesth. 2005;52:548-9.
Cameron E, Johnston G, Crofts S, Morton NS. The minimum effective dose of lignocaine to prevent injection pain due to propofol in children. Anaesthesia. 1992;47:604-6.
Tan CH, Onsiong MK. Pain on injection of propofol: Anaesthesia. 1998;53:468-76.
Smith I, White PF, Nathanson M, Gouldson R. Propofol. An update on its clinical use. Anesthesiology. 1994;81:1005-43.
Coderre TJ, Katz J, Vaccarino AL, Melzack R. Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence. Pain. 1993;52:259-85.
McCrirrick A, Hunter S. Pain on injection of propofol: the effect of injectate temperature. Anaesthesia. 1990;45:443-4.
Nathanson MH, Gajraj NM, Russell JA. Prevention of pain on injection of propofol: a comparison of lidocaine with alfentanil. Anesth Analg. 1996;82:469-71.
Kobayashi Y, Kamada Y, Kumagai A. Pain-free injection of propofol. Masui. 1998;47:835-8.
Bekker A, Sturaitis MK. Dexmedetomidine for neurological surgery. Neurosurgery. 2005;57:1-10.
Khan ZP, Ferguson CN, Jones RM. alpha-2 and imidazoline receptor agonists. Their pharmacology and therapeutic role. Anaesthesia. 1999;54:146-65.
Ayoglu H, Altunkaya H, Ozer Y. Does dexmedetomidine reduce the injection pain due to propofol and rocuronium? Eur J Anaesthesiol. 2007;24:541-5.
Bahar M, McAteer E, Dundee JW, Briggs LP. Aspirin in the prevention of painful intravenous injection of disoprofol (ICI35,868) and diazepam (Valium). Anaesthesia. 1982;37:847-8.
Helmers JH, Kraaijenhagen RJ, Leeuwen L, Zuurmond WW. Reduction of pain on injection caused by propofol. Can J Anaesth. 1990;37:267-8.
Basaranoglu G, Erden V, Delatioglu H. Reduction of pain on injection of propofol: a comparison of fentanyl with remifentanil. Anesth Analg. 2002;94:1040-1.
Dalle C, Schneider M, Clergue F. Inhibition of the I(h) current in isolated peripheral nerve: a novel mode of peripheral antinociception? Muscle Nerve. 2001;24:254- 61.
James MK, Feldman PL, Schuster SV. Opioid receptor activity of GI 87084B, a novel ultra-short acting analgesic, in isolated tissues. J Pharmacol Exp Ther. 1991;259:712- 8.
Newcombe GN. The effect, on injection pain, of adding lignocaine to propofol. Anaesth Intensive Care. 1990;18:105-7.
How to Cite
Copyright (c) 2023 European Journal of Therapeutics
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.