Prevention of pain on injection of propofol: a comparison of lidocaine with different doses of paracetamol.
OBJECTIVE
The aim of this study was to compare the efficacy of pretreatment with paracetamol 0.5 mg kg(-1), 1 mg kg(-1), 2 mg kg(-1) and lidocaine 0.5 mg kg(-1) for prevention of propofol induced pain.


METHODS
In this double-blind, placebo-controlled study, 250 adult patients ASA I or II, scheduled to undergo elective surgery, were randomly assigned into five groups of 50 each. Group P0.5, group P1 and group P2 received 0.5, 1 and 2 mg kg(-1) paracetamol respectively; group L received 0.5 mg kg(-1) lidocaine; and the control group, group C, received isotonic saline pretreatment in the dorsum of the hand, followed by propofol 1 min later. A blinded researcher assessed the patient's pain level via a four-point scale.


RESULTS
There were no significant differences in patient characteristics among the groups. The incidence of propofol injection pain in all treatment groups was significantly lower than in the control group (P < 0.001). When the paracetamol 0.5 mg kg(-1) group was compared with both the paracetamol 1 mg kg(-1) group (P < 0.01) and the paracetamol 2 mg kg(-1) group (P < 0.001), significant differences were observed. In the lidocaine 0.5 mg kg(-1) group propofol injection pain was significantly reduced compared with the paracetamol 0.5 mg kg(-1) group (P < 0.01). However, in the paracetamol 2 mg kg(-1) group pain was more significantly reduced than in the lidocaine 0.5 mg kg(-1) group (P < 0.001). In the paracetamol 2 mg kg(-1) group the incidence of pain was significantly less than in paracetamol 1 mg kg(-1) group (P < 0.001).


CONCLUSIONS
When given as venous retention pretreatments 1 min before propofol, paracetamol 1 mg kg(-1) and lidocaine 0.5 mg kg(-1) were equally effective in attenuating pain during intravenous (i.v.) injection of propofol whereas pretreatment with paracetamol 2 mg kg(-1) was shown to be the most effective treatment.
Borazan
Hale
H
Department of Anesthesiology and Reanimation, Selcuk University Medical Faculty, Konya, Turkey. hborazan@hotmail.com
Erdem
Tuba B
TB
Kececioglu
Melahat
M
Otelcioglu
Seref
S
D000082:Acetaminophen / Q000008:administration & dosage*; D000328:Adult; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced* / Q000517:prevention & control*; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects*; D011446:Prospective Studies
D000082:Acetaminophen; D008012:Lidocaine; D015742:Propofol