title: A prospective, randomized, double-blind study to compare the efficacy of lidocaine + metoclopramide and lidocaine + ketamine combinations in preventing pain on propofol injection.
abstract: OBJECTIVE
  Propofol injection is known to cause distressing pain, and various methods have been used to decrease this pain. We investigated the efficacy of the lidocaine + metoclopramide and lidocaine + ketamine combinations on modulating propofol injection pain.
  
  
  METHODS
  Ninety ASA I/II patients aged 20-60 years were randomly assigned to three groups to receive lidocaine 20 mg (group L), lidocaine 20 mg + metoclopramide 10 mg (group LM), or lidocaine 20 mg + ketamine 5 mg (group LK), respectively, with venous occlusion for 1 min using a forearm tourniquet. Propofol 0.5 mg/kg was subsequently administered into a dorsal hand vein, and pain was assessed during its injection using a verbal rating score. The results were analyzed statistically with analysis of variance, the chi-square test, and the Wilcoxon rank sum test, where appropriate. The significance level was set at p < 0.05.
  
  
  RESULTS
  The incidence of pain was rated to be significantly less in patients in groups LM (40 %) and LK (6.7 %) than in those in group L (83.3 %) (p = 0.001 and p < 0.001, respectively). The pain score [median (range)] was also significantly less in patients in groups LM [0 (0-3)] and LK [0 (0-2)] than in those in group L [2 (0-3)] (p = 0.001 for both groups).
  
  
  CONCLUSIONS
  The lidocaine-ketamine combination is most effective for decreasing the pain on propofol injection.
authors.affiliation: Department of Anesthesiology and Intensive Care, G B Pant Hospital & Associated Maulana Azad Medical College, New Delhi, India. kapsdr@yahoo.com
authors.forename: Kapil
authors.initials: K
authors.lastname: Chaudhary
authors.forename: Pramod
authors.initials: P
authors.lastname: Gupta
authors.forename: Anoop Raj
authors.initials: AR
authors.lastname: Gogia
mesh_terms: D000328:Adult; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D000932:Antiemetics / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects*; D011446:Prospective Studies
chemical_list: D019162:Anesthetics, Combined; D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D000932:Antiemetics; D007649:Ketamine; D008012:Lidocaine; D008787:Metoclopramide; D015742:Propofol