Publications

Abstract
Introduction: Propofol (2,6 diisopropyl phenol) is widely used agent for induction of anaesthesia, although the pain during
its injection remains a concern for all anaesthesiologists. The incidence of Propofol injection pain (PIP) varies between 28% to
90% in adults. Despite several interventions and pretreatment with drugs to alleviate pain, the failure rate is 1332%. The aim
of this study was to find the most efficacious method of alleviating PIP by combining intervention of venous occlusion along
with Lignocaine, Dexamethasone or Ondansetron pretreatment. Methods: This is a double blinded randomized prospective
clinical study on adult patients between the age group of 1859 years scheduled for elective general surgical procedures. 150
patients were randomly allocated through computer generated table into three groups scheduled to receive 2ml of Lignocaine
(20mg), Ondansetron (4mg) or Dexamethasone (6mg). Drugs were administered after tourniquet application inflated to 40mm
Hg and occlusion was released after 30 seconds and then 0.5mg/kg of propofol was administered at the rate of 0.5ml / sec. The
blinded investigator evaluated the pain score using the four point scale at 15 second interval. Statistical analysis was made by
SPSS version 16. Results: The incidence and intensity of pain in patients receiving Lidocaine and Dexamethasone were significantly
lower than those receiving Ondansetron (p<0.001). Conclusion: Pretreatment with intravenous Dexamethasone and Lidocaine
along with venous occlusion for 30 seconds was found to be equally effective in reducing Propofol injection pain. Both these
drugs were found to be superior to Ondansetron in achieving this goal.
Keywords: Propofol; Ondansetron; Dexamethasone; Lidocaine; Pain; Injection