Attenuation of propofol induced pain by thiopentone sodium, fentanyl and lignocaine: A comparative study

Abstract

Propofol is one of the most popular intravenous anaesthetic used for induction and maintenance of anaesthesia and sedation in and outside of operating room. Its role is valuable especially for day care surgeries and with larngeal mask airways. Because of high incidence of pain on propofol injection (POPI) numerous interventions have been tested to prevent this pain including the use of different drugs and physical measures as well as the combination of methods. In this. study the effect of pretreatment with thiopentone sodium, preservative free fentanyl, and preservative free 2% lignocaine on reducing propofol induced pain with 4 point pain scale. A prospective observational study was conducted in Government Medical College, Kottayam in 63 patients (ASA 1 and 2) in the age group of 18-60 years scheduled for elective surgery under general anaesthesia. Selected patients were allocated into 3 groups: Group T, Group F and Group L. Prior to propofol injection, Group T received thiopentone sodium 0.5mg/kg, Group F received preservative free fentanyl 2 mcg/kg and Group L received preservative free lignocaine 1 mg/kg and pain on propofol injection was assessed during induction of anaesthesia. All patients post induction received standard general anaesthesia. The lowest incidences of pain on propofol injection were observed in Group T, whereas Group L and Group F shown the same incidences of pain on propofol injection. There were no statistically significant differences in the pain perceived between three groups, group L, group F and group T (47.7 v/s 47.7% v/s 33.3%, p=0.170) on propofol injection. Thiopentone sodium was not significantly different from lignocaine for reducing pain during injection of propofol in this study. Fentanyl is equally effective as lignocaine in reducing such pain. The pretreatment with preservative free fentanyl and thiopentone sodium reduced the incidence of propofol induced pain similar to preservative free 2% lignocaine.