The effects of alfentanil or remifentanil pretreatment on propofol injection pain.
OBJECTIVE
To compare the efficacy of alfentanil, remifentanil, and saline in minimizing the propofol injection pain.


METHODS
Randomized, double-blind study.


METHODS
University hospital.


METHODS
175 ASA physical status I and II, adult female patients undergoing minor gynecological procedures with general anesthesia.


METHODS
Unpremedicated patients were randomly allocated to one of four groups. Patients received 2 mL (1 mg) of alfentanil (n=43), 2 mL of remifentanil 0.01 mg (n = 43), 2 mL of remifentanil 0.02 mg (n=45), or 2 mL of saline (n=44) 30 seconds prior to administration 5 mL of propofol 1%.


METHODS
Patients were asked whether they had pain due to propofol injection. Their pain scores were evaluated with a Visual Analogue Scale. In the Postanesthesia Care Unit, frequency of postoperative nausea, vomiting, hypotension, and flushing were all determined.


RESULTS
The remifentanil and alfentanil groups showed significantly less frequency and severity of pain than the saline group (p <0.05). When the alfentanil group was compared with the remifentanil groups, significant differences in pain relief associated with injection of propofol (p <0.001) were noted. Remifentanil 0.02 mg relieved pain associated with injection of propofol more effectively than remifentanil 0.01 mg (p <0.001).


CONCLUSIONS
The remifentanil and alfentanil groups showed significantly less frequency and severity of pain than did the saline group. Remifentanil was effective in preventing propofol injection pain, and should be used at a dose of at least 0.02 mg for this purpose. Remifentanil may be an alternative drug for prevention of propofol injection pain.
Iyilikci
Leyla
L
Department of Anesthesiology, Dokuz Eylul University, School of Medicine, Izmir-Turkey, Turkey. leyla.iyilikci@deu.edu.tr
Balkan
Bahar Kuvaki
BK
Gökel
Erol
E
Günerli
Ali
A
Ellidokuz
Hülya
H
D000328:Adult; D015760:Alfentanil / Q000008:administration & dosage / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced / Q000188:drug therapy*; D010147:Pain Measurement; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use*; D015742:Propofol / Q000009:adverse effects*; D000077208:Remifentanil
D018686:Anesthetics, Intravenous; D010880:Piperidines; D015760:Alfentanil; D000077208:Remifentanil; D015742:Propofol