RESUMO
Propofol is one of the safest drugs for induction of general anaesthesia. Routinely available preparation in the market being propofol LCT (long chain triglycerides) has the disadvantage of pain on injection. This pain is very discomforting for the patient and also to the anaesthesiologist. So, they are coming up with a new preparation propofol MCT (medium chain triglycerides) which causes less pain on injection. We wanted to compare the occurrence of pain on injection of Propofol MCT with Propofol LCT.METHODSAfter obtaining institutional ethical committee approval, 150 patients undergoing various elective surgeries under general anaesthesia where propofol was used as an induction agent, aged between 18 and 65 years of ASA I & II were enrolled in the study. The study patients were divided into two groups. Group M, who received Propofol MCT and group L, who received Propofol LCT as an induction drug. The intensity of pain was evaluated by using Visual Analogue Score (VAS). Similarly change of triglyceride levels after single induction dose of Propofol MCT and Propofol LCT were observed.RESULTSGroup M showed reduced pain score (4.15±1.90) after injection along with less incidence of pain compared to Group L (6.37±2.49). Serum triglyceride levels had no significant difference in preoperative and postoperative values.CONCLUSIONSPain on injection with Propofol MCT (4.15 ± 1.90) is less compared to Propofol LCT (6.37± 2.49) & no evidence of change of triglyceride levels was seen after a single induction dose in the study.
RESUMO
BACKGROUND: Propofol produces anesthesia with rapid recovery but also causes pain on injection. This study was designed to evaluate the effects of two different concentrations of remifentanil for minimizing the pain caused by propofol and to compare the hemodynamic changes during propofol-remifentanil infusion. METHODS: In a randomized, double-blind study of 80 patients, we compared the severity of the injection pain of propofol between two groups of patients. The initial effect-site target concentration of remifentanil was set at 4 ng/ml (the R4 group, n = 40) or 8 ng/ml (the R8 group, n = 40). After the effect-site concentration of remifentanil was achieved, the infusion of propofol was started with the concentration of 4 microgram/ml. The remifentanil-related complications were evaluated and the severity of the pain caused by propofol was compared by using a four-point scale during the propofol infusion. The heart rate and arterial blood pressure were measured at pre-induction, just before intubation and at 1 minute after intubation. RESULTS: The severity of injection pain of propofol was significantly lower in the R8 group than in the R4. There was no significant difference in the incidence of remifentanil-related complications between the two groups. Compared with the pre-induction values, the heart rate and arterial blood pressure were significantly lower at pre-intubation and at 1 minute after intubation in the R4 and R8 groups. CONCLUSIONS: Pretreatment with an effect-site concentration of 8 ng/ml remifentanil may be useful for minimizing the propofol injection pain compared with 4 ng/ml remifentanil.