Pain on injection of propofol: comparison of metoprolol with lidocaine.
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.
Aşik
I
I
University of Ankara, Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Ankara, Turkey. iasik@yahoo.com
Yörükoğlu
D
D
Gülay
I
I
Tulunay
M
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000704:Analysis of Variance; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000627:therapeutic use; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008012:Lidocaine / Q000627:therapeutic use*; D008790:Metoprolol / Q000627:therapeutic use*; D010146:Pain / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008012:Lidocaine; D008790:Metoprolol; D015742:Propofol