title: Sevoflurane to alleviate pain on propofol injection.
abstract: OBJECTIVE
  Since the introduction of propofol, several drugs and methods have been used to alleviate the pain on its injection. This study was designed to evaluate the effect of adding sevoflurane 3% during preoxygenation in alleviation of pain on propofol injection.
  
  
  METHODS
  In this randomized single-blinded study, 100 patients were randomly allocated equally into five groups: sevoflurane-lidocaine-tourniquet (SLT), sevoflurane-lidocaine (SL), lidocaine-tourniquet (LT), lidocaine (L), and sevoflurane (S). Approximately 10 min before the induction of anesthesia, midazolam 1-2 mg was administered intravenously to all patients. All patients received fentanyl 1 µg/kg as pretreatment and a full induction dose of propofol. A blinded anesthesia nurse assessed pain and hand movements throughout the injection of propofol.
  
  
  RESULTS
  In the SLT group, all patients (100%) were pain free and had no hand movements. There was no significant difference in pain grade or in hand movements between the L and the S groups, or between the SLT and the SL groups. However, significant differences were observed in pain grade between the SLT and the L groups as well as between the SLT and the S groups. In addition, a significant difference in hand movement was observed only between the SLT and the S groups.
  
  
  CONCLUSIONS
  The addition of 3% sevoflurane at the time of preoxygenation for 1 min along with routine use of lidocaine-tourniquet completely prevented pain upon propofol injection, whereas sevoflurane by itself provided similar analgesia to premixed lidocaine with propofol.
authors: Department of Anaesthesia and ICU, Al Salam International Hospital, 35151, Kuwait, Kuwait. kalindidesousa@gmail.com
authors: Kalindi
authors: K
authors: DeSousa
authors: Mohamed Shaaban
authors: MS
authors: Ali
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008874:Midazolam / Q000008:administration & dosage; D010146:Pain / Q000139:chemically induced* / Q000188:drug therapy*; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D000077149:Sevoflurane; D016037:Single-Blind Method; D014111:Tourniquets
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D008012:Lidocaine; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol