title: Efficacy of different fluids preload on propofol injection pain: A randomized, controlled, double-blinded study.
abstract: Injection pain of propofol remains a common clinical problem. Previous studies demonstrated that propofol injection pain was alleviated by applying nitroglycerin ointment to the skin of injection site, which inspires us to test whether venous vasodilation induced by fluid preload could alleviate the pain. Different types or volumes of fluid preload were compared. 200 ASA I-II adult patients were randomly assigned to five groups of 40 each. A 20 G cannula was established on the dorsum or wrist of the hand. When fluid preload given with Plasma-Lyte A 100 mL (P100 group), 250 mL (P250 group), 500 mL (P500 group), 0.9% saline 500 mL (N500 group) or Gelofusine 500 mL (G500 group) was completed within 30 min, respectively, Propofol (0.5 mg/kg, 1%) was injected at a rate of 0.5 mL/s. A blind investigator assessed the pain using a four-point scale. Incidence of pain in P100, P250, and P500 groups was 87.5%, 57.5% and 35%, respectively (P<0.05). The median pain intensity score was significantly lower in P500 group than that in P250 and P100 groups (P<0.05 and P<0.01, respectively). Comparison of the effect of different types of solution preload indicated that the highest incidence of pain was in N500 group (62.5%) (N500 vs. P500, P=0.014; N500 vs. G500, P=0.007). The median pain intensity score in N500 group was higher than that in P500 group (P<0.05) and G500 group (P<0.05). There was no significant difference between P500 and G500 groups. It is suggested that Plasma-Lyte A or Gelofusine preload with 500 mL before propofol injection is effective in alleviating propofol-induced pain.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Shi-Ying
authors.initials: SY
authors.lastname: Yuan
authors.affiliation: Department of Anesthesiology, Affiliated Hospital of Zunyi Medical College, Zunyi, 563000, China.
authors.forename: Tian-Yuan
authors.initials: TY
authors.lastname: Luo
authors.affiliation: Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, 100730, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. franklinyun@hust.edu.cn.
authors.forename: Yun
authors.initials: Y
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004573:Electrolytes / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000627:therapeutic use*; D011097:Polygeline / Q000008:administration & dosage / Q000627:therapeutic use*; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D004573:Electrolytes; D010952:Plasma Substitutes; D011097:Polygeline; C048013:Plasmalyte A; D015742:Propofol
keywords: Gelofusine; Plasma-Lyte A; fluid preload; injection pain; propofol