Pain during injection of propofol: the effect of prior administration of butorphanol.
Propofol causes pain or discomfort on injection in 28%-90% of patients. A number of techniques have been tried for minimizing propofol-induced pain with variable results. We compared the efficacy of butorphanol and lidocaine for prevention of propofol-induced pain. One-hundred-fifty ASA I-II adults, undergoing elective surgery were randomly assigned into 3 groups of 50 each. Group I (NS) received normal saline, Group II (L) received lidocaine 2% (40 mg), and Group III (B) received butorphanol 2 mg. All patients received pretreatment solutions made in 2 mL with normal saline administered over 5 s. One min after pretreatment patients received one-fourth of the total calculated dose of propofol (2.5 mg/kg) over 5 s. Assessment of pain with IV propofol was done by using a four-point scale: 0 = no pain, 1 = mild pain, 2 = moderate pain and 3 = severe pain at the time of propofol injection. In the control Group 39 (78%) patients had pain during propofol injection as compared to 21 (42%) and 10 (20%) in the lidocaine and butorphanol groups, respectively (P < 0.05). Butorphanol was the most effective. We therefore suggest the IV pretreatment with butorphanol 2 mg for attenuation of pain associated with propofol injection.
Departments of Anesthesia and Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Anil
A
Agarwal
Mehdi
M
Raza
Sanjay
S
Dhiraaj
Ravinder
R
Pandey
Devendra
D
Gupta
Chandra Kant
CK
Pandey
Prabhat K
PK
Singh
Uttam
U
Singh
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000494:pharmacology; D002077:Butorphanol / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000494:pharmacology; D008297:Male; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement / Q000187:drug effects; D015742:Propofol / Q000009:adverse effects*
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008012:Lidocaine; D002077:Butorphanol; D015742:Propofol