Effect of injection pain and withdrawal movement of propofol and rocuronium in the induction of anaesthesia on postoperative pain outcomes in gynaecological laparoscopic surgery: a prospective observational study

Abstract

INTRODUCTION The pain experience among individuals may differ from each other. This prospective cohort study aimed to determine the impact of injection pain/withdrawal movement of propofol and rocuronium in the induction of anaesthesia on postoperative pain outcomes in gynaecologic laparoscopic surgery. METHODS A total of 100 patients aged 19–60 years received propofol and rocuronium injections for the induction of anaesthesia. The incidence of propofol injection pain (PIP) and rocuronium-induced withdrawal movement (RIWM), postoperative pain scores and total opioid consumption were evaluated, and the associations between PIP/RIWM and postoperative pain outcomes were determined RESULTS Visual analog scale (VAS) for pain after surgery and total opioid consumption after surgery in patients with PIP or RIWM were significantly higher than in patients without PIP or RIWM. The correlation between PIP and RIWM, VAS at 1 hour, VAS at 24 hours, total opioid consumption were significant and weakly positive (r = 0.249, r = 0.234, r = 0.22, r = 0.234, respectively). Compared with PIP, RIWM correlated more positively with pain score at 1 hour (r = 0.408 vs. r = 0.234, RIWM vs. PIP) and 24 hours (r = 0.398 vs r = 0.227, RIWM vs. PIP) and total opioid consumption after 48 hours (r = 0.457 vs. r = 0.234, RIWM vs. PIP). CONCLUSION During anaesthesia induction, the occurrence of PIP and RIWM may predict the severity of postoperative pain and total opioid consumption, with RIWM emerging as a stronger predictor than PIP.

Effect of optimizing the induction regimen of drugs in preventing cough reactions in patients undergoing general anesthesia: a single-center, randomized, controlled trial

“…At the same time, among the induction drugs, lidocaine has the best effect on preventing opioid cough and suppressing emergency response to endotracheal intubation [10][11][12]. Injection of propofol before rocuronium can avoid pain caused by rocuronium injection when the patient is awake; moreover, the injection pain caused by rocuronium bromide is more severe than that of propofol [13,14]. Therefore, the preferential intravenous injection of propofol can cause the patient to sleep while taking advantage of the analgesic effect of lidocaine [4,15], and when combined with diluted rocuronium bromide, this can ultimately reduce or avoid the pain of rocuronium bromide injection.…”