BACKGROUND: Pain following injection of Propofol occurs in 28-90 % of patients. Various methods have been used to reduced the pain on intravenous injection of propofol namely administration of drugs like alfentanil, metoclopramide, pretreatment with intravenous lignocaine, pretreatment with intravenous ketamine etc., AIMS: In this study, we aimed to evaluate and compare the effect of pretreatment of ketamine and lignocaine on propofol injection pain. STUDY DESIGN: Randomised controlled study. METHODS: 120 patients of ASA grade I and II of both sexes between 18-60 years of age group scheduled for various elective surgical procedures, were randomly allocated into three groups of 40 each by envelope method using random number table. Patients of Group K (n=40) received ketamine 10 mgs (1 ml), Patients of Group L (n=40) received lignocaine 10 mgs (1 ml) and patients of Group S (n=40) received 0.9% normal saline (1 ml). In all these patients injection propofol (1%) was administered intravenously over a period of 5 seconds. 15 seconds later patients were asked about the presence of injection pain. RESULTS: Pain on Injection of propofol was assessed using the "Verbal categorical scoring system." Asked the patient to grade pain as no pain, mild pain or severe pain. They were score as 0, 1, or 2 respectively. The overall incidence of pain in control group (normal saline group) was 80%, Incidence of pain in ketamine group was 20 %, incidence of pain in lignocaine group was 30%. When compared between these two groups, ketamine significantly reduces pain as compared to lignocaine, which was not statistically significant (P>0.05). CONCLUSION: We conclude that both ketamine and lignocaine are effective in reducing the pain of intravenous injection of propofol, However ketamine is superior to lignocaine.
Introduction: Among the depolarizing muscle relaxants, Succinylcholine is the widely used depolarizing agent until today in anaesthesia practice. Side effects like hyperkalemia, fasciculations, myalgia, increased intracranial pressure and intraocular pressure are common with the use of this drug. Pretreatment with various drugs have been proven to lessen these side effects. In our study, low dose of oral pregabalin was used as a premedication to assess its effects on the incidence and severity of fasciculations and postoperative myalgia caused by Succinylcholine administration. Materials and Methods: 60 patients of either gender undergoing elective ENT surgeries under general anaesthesia were randomly allocated to two groups of 30 each. Patients in Group PG (pregabalin group) received 75 mg of pregabalin orally 1 h prior to surgery and patients in Group CG (control group) received matching placebo. Fasciculations and myalgia grading was done by a blinded observer. Haemodynamic variables were measured at regular intervals. Results: Both groups were comparable in regard to Demographic data (p > 0.05). We didn't find any significant difference in the fasciculations incidence (p=0.702) and myalgia incidence (p=0.081) between the two groups. But the severity of fasciculations is statistically significant between the groups (< 0.001). After 24 h of surgery, severity of myalgia is mild (86.9%) in PG group when compared to CG group which was of moderate variety (80.7%) (P < 0.001). Conclusion:Low dose oral pregabalin-75 mg decreases the severity of succinylcholine-induced fasciculations and myalgia. There is not much effect on the incidence of fasciculations and myalgia in patients undergoing elective ENT surgeries.
Postoperative pain is the most annoying symptom that every patient will complain after the surgery. Relief of this pain greatly improves the patient satisfaction, compliance and recovery. Opioids and NSAIDs are the most commonly used analgesics in the postoperative period. The need for the study was to compare the efficacy of intravenous Nalbuphine over intravenous Paracetamol in the postoperative period. Materials and Methods: 60 patients who underwent elective surgeries under general anaesthesia were selected for the study. 30 patients in Group P received Inj. Paracetamol 15 mg/kg body wt. and 30 patients in Group N received Inj. Nalbuphine-0.15 mg/kg body wt over 15 min. Both the groups received the study drug half an hour before the completion of surgery. Postoperative pain scores were measured using VAS pain score and postoperative haemodynamic parameters were measured at regular intervals. The time for the first dose of rescue analgesia was noted. Side effects like sedation, nausea, vomiting, pruritus were assessed at regular intervals postoperatively until 10 hours. Results: Demographic profile were comparable between the groups. Both Nalbuphine and Paracetamol can be effectively used for treating postoperative pain. But Nalbuphine is used as safer alternative since the duration of analgesia is longer in Nalbuphine group when compared to Paracetamol group without significant side effects. Haemodynamic stability was maintained in both the groups. Conclusions: IV Nalbuphine is a better cost effective alternative to IV Paracetamol in alleviating the postoperative pain with prolonged duration of analgesia and hemodynamic stability without significant side effects.
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