Role of tramadol in reducing pain on propofol injection.

Department of Anaesthesia, National University Hospital, Singapore.
Singapore medical journal (Impact Factor: 0.63). 05/2001; 42(5):193-5.
Source: PubMed

ABSTRACT Propofol is frequently associated with pain on injection. We evaluated the effect of tramadol in a randomised, double-blind study using a tourniquet venous retention technique. Normal saline placebo was given intravenously to patients in Group 1 (n = 30),tramadol 50 mg to Group 2 (n = 30), and lignocaine 50 mg to Group 3 (n = 30). The venous retention of drugs was maintained for 1 minute, followed by tourniquet release and intravenous administration of propofol. Pain assessment was made immediately after propofol injection. There was a significant reduction in the incidence of pain associated with propofol administration in patients pretreated with lignocaine and tramadol (P < 0.05). In addition, pretreatment with tramadol was as effective as lignocaine in reducing pain on propofol injection.

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    ABSTRACT: Background: Propofol (2,6-di-isopropylphenol) used for the induction of anesthesia often causes mild to severe pain or discomfort on injection, for which various methods have been tried, but with conflicting results. Objective: The present study involved pretreatment with lignocaine, fentanyl and placebo for prevention of pain on propofol injection to determine the difference in efficacy of fentanyl 100 μg compared with lignocaine 40 mg. Materials and Methods: Sixty-three participants of either sex, between 18 and 60 years of age, belonging to ASA physical status 1 and 2, undergoing elective surgery under general anesthesia, were randomized into three equal groups of 21 participants. They received, intravenously, either lignocaine (20 mg/mL) or fentanyl (50 μg/mL) or placebo (normal saline 2 mL) pretreatment before the propofol injection. Results: The three groups were comparable with respect to age, height, weight, sex and ASA physical status. The incidences of pain on pretreatment drug injection was higher in the fentanyl group (33.3%) compared with lignocaine and normal saline (P<0.05). The lowest incidence of pain on propofol injection was observed in the lignocaine pretreatment group (14.3%) compared with fentanyl (42.9%) and normal saline (71.4%) (P<0.05). There was no significant difference in adverse skin reaction within groups. In the normal saline pretreatment group, 38.1% of the participants experienced severe pain, compared with 9.5% in the fentanyl (P<0.05) group; none with lignocaine. The number needed to treat was 2 in the lignocaine pretreatment group compared with 4 in the fentanyl pretreatment group. Conclusion: Compared with fentanyl, lignocaine pretreatment was more effective in preventing pain on propofol injection.
    01/2011; 5(1):33. DOI:10.4103/0259-1162.84180
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    ABSTRACT: Propofol injection pain, despite various strategies, remains common and troublesome. This study aimed to test the hypothesis that pretreatment with the combination of intravenous lidocaine and magnesium would have an additive effect on reducing propofol injection pain.
    Journal of Anesthesia 08/2014; DOI:10.1007/s00540-014-1892-9 · 1.12 Impact Factor
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    ABSTRACT: Background and objectives Injection pain after propofol administration is common and may disturb patients’ comfort. The aim of this study was to compare effectiveness of intravenous (iv) nitroglycerin, lidocaine and metoprolol applied through the veins on the dorsum of hand or antecubital vein on eliminating propofol injection pain. Method There were 147 patients and they were grouped according to the analgesic administered. Metoprolol (n = 31, Group M), lidocaine (n = 32, Group L) and nitroglycerin (n = 29, Group N) were applied through iv catheter at dorsum hand vein or antecubital vein. Pain was evaluated by 4 point scale (0 – no pain, 1 – light pain, 2 – mild pain, 3 – severe pain) in 5, 10, 15 and 20th seconds. ASA, BMI, patient demographics, education level and the effect of pathways for injection and location of operations were analyzed for their effect on total pain score. Results There were no differences between the groups in terms of total pain score (p = 0.981). There were no differences in terms of total pain score depending on ASA, education level, location of operation. However, lidocaine was more effective when compared with metoprolol (p = 0.015) and nitroglycerin (p = 0.001) among groups. Although neither lidocaine nor metoprolol had any difference on pain management when applied from antecubital or dorsal hand vein (p > 0.05), nitroglycerin injection from antecubital vein had demonstrated statistically lower pain scores (p = 0.001). Conclusion We found lidocaine to be the most effective analgesic in decreasing propofol related pain. We therefore suggest iv lidocaine for alleviating propofol related pain at operations.
    Revista Brasileira de Anestesiologia 09/2014; DOI:10.1016/j.bjan.2014.01.006 · 0.42 Impact Factor


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