Propofol induced pain; Comparison between effects of lidocaine propofol mixture and metoclopramide premedication

ABSTRACT

Propofol causes pain on injection in 28% - 90% of patients. A number of techniques have been tried for minimizing propofol-induced pain with variable results.To compare the use of premixed lidocaine-propofol with metoclopramide pretreatment for the reduction of pain during injection of propofol in adult patients. A prospective, double blind, randomized, placebo-controlled study. Shiraz University Hospital, Department of Anesthesiology, Shiraz, Iran. From Jan 2007 to Dec 2007. 202 subjects [ASA I-II] scheduled for elective operations under general anesthesia were allocated into three groups and treated as follows Group A 20 ml propofol mixed with 20mg lidocaine%1 following 2ml normal saline; Group B 20 ml propofol mixed with 2ml normal saline following 5 mg metoclopramide; Group C [control group] 20 ml propofol mixed with 2 ml normal saline following 2 ml normal saline. Pain intensity was graded by a single, blinded observer and recorded as either severe, moderate, mild or no pain according to the response of the patients to the injection. The incidence of pain was 72% in placebo group compared to 58.7% in the metoclopramide and 28.8% in the lidocaine group. Propofol-lidocaine admixture is more effective than metoclopramide pre treatment in decreasing the pain of propofol injection