title: Comparative evaluation of the effect of remifentanil and 2 different doses of esmolol on pain during propofol injection: A double-blind, randomized clinical consort study.
abstract: BACKGROUND
  Propofol is associated with pain during injection, which is stressful to patients. The present study was designed to investigate the analgesic effect of pretreatment with remifentanil and esmolol in minimizing propofol injection pain, compared with placebo.
  
  
  METHODS
  In a randomized, double-blind, prospective trial, 120 patients, scheduled for elective dental surgery under general anesthesia, were randomized to 1 of the 4 treatment arms (n = 30 each) receiving normal saline, remifentanil 0.35 μg/kg, esmolol 0.5 mg/kg, and 1 mg/kg before administration of propofol. During injection of 1% propofol 0.5 mg/kg, pain was evaluated by a 4-point score (0 = none, 1 = mild, 2 = moderate, 3 = severe). Any adverse effects such as hypotension and bradycardia were recorded during the perioperative periods.
  
  
  RESULTS
  In all, 120 patients completed this study. There were no significant differences in terms of demographic data. The incidence of pain on injection of propofol was 11 (36.7%) with remifentanil 0.35 μg/kg, 12 (40%) with esmolol 0.5 mg/kg, and 11 (36.7%) with esmolol 1 mg/kg, compared with 25 (83.3%) with normal saline (respectively, P < 0.05). There were no significant differences in the incidence of pain between groups with remifentanil 0.35 μg/kg, and esmolol 0.5 mg/kg and 1 mg/kg. There were no emergence reactions such as hypotension and bradycardia in all groups.
  
  
  CONCLUSIONS
  Pretreatment with esmolol 0.5 mg/kg and 1 mg/kg and remifentanil 0.35 μg/kg equally decreased pain during propofol injection.
authors.affiliation: Department of Oral and Maxillofacial surgery, School of Dentistry Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea.
authors.forename: Myunghwan
authors.initials: M
authors.lastname: Lee
authors.forename: Taegeon
authors.initials: T
authors.lastname: Kwon
authors.forename: Sujin
authors.initials: S
authors.lastname: Kim
authors.forename: Saeyoung
authors.initials: S
authors.lastname: Kim
authors.forename: Kibum
authors.initials: K
authors.lastname: Park
authors.forename: Younghoon
authors.initials: Y
authors.lastname: Jeon
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage*; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage*; D011412:Propanolamines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage; D000077208:Remifentanil
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D010880:Piperidines; D011412:Propanolamines; C036604:esmolol; D000077208:Remifentanil; D015742:Propofol