title: The effects of alfentanil or remifentanil pretreatment on propofol injection pain.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Dokuz Eylul University, School of Medicine, Izmir-Turkey, Turkey. leyla.iyilikci@deu.edu.tr
authors.forename: Leyla
authors.initials: L
authors.lastname: Iyilikci
authors.forename: Bahar Kuvaki
authors.initials: BK
authors.lastname: Balkan
authors.forename: Erol
authors.initials: E
authors.lastname: Gökel
authors.forename: Ali
authors.initials: A
authors.lastname: Günerli
authors.forename: Hülya
authors.initials: H
authors.lastname: Ellidokuz
mesh_terms: 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
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D015760:Alfentanil; D000077208:Remifentanil; D015742:Propofol