Gabapentin pretreatment for propofol and rocuronium injection pain: A randomized, double-blind, placebo-controlled study

Çakırgöz, Mensure Yılmaz; Demirel, İsmail; Duran, Esra; Özer, Ayşe Belin; Türkmen, Ülkü Aygen; Ersoy, Ayşın; Aksu, Ahmet; Hancı, Volkan

doi:10.4103/1119-3077.224791

Cited by 5 publications

(4 citation statements)

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“…The reported incidence of painful propofol injection varies widely, between 28% and 91% in the literature, and 38% in this current study 12,13 . Many medications have been investigated and demonstrated some efficacy in reducing this incidence, including ondansetron, dexamethasone, lidocaine, magnesium sulfate, ketamine, gabapentin, and nitroglycerine 1–10 . Other modalities have also shown some utility including alteration of the injectate temperature, manual palpation of the intravenous site, Valsalva maneuver, and use of auto-coinduction 11,14–19 …”

Section: Discussionmentioning

confidence: 75%

“…Its ability to provide a smooth induction and rapid recovery are significant advantages that have contributed to its widespread use; however, one of its significant drawbacks is pain on injection. Numerous studies have previously examined the use of medications in the reduction of pain with propofol infusion with varying degrees of efficacy 1–10 . To our knowledge, the analgesic effect of vibration on pain with propofol infusion has not previously been investigated.…”

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confidence: 99%

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The Effect of Vibration on Pain During Intravenous Injection of Propofol

Hwang¹,

Nash²,

Yedlin

et al. 2021

Ann Plast Surg

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Purpose Pain is a common side effect of intravenous injection of propofol. We conducted a randomized, prospective, single-blinded controlled trial to assess the efficacy of vibration analgesia on pain during propofol infusion in ambulatory surgery. Methods After institutional review board approval, 100 patients undergoing elective ambulatory surgery with general anesthesia were randomized into 2 groups. A control group (n = 50) consisted of patients who received infusion of propofol without vibration analgesia. A treatment group (n = 50) consisted of patients who received infusion of propofol with vibration analgesia using the Buzzy device. Pain was assessed using a 4-point pain manifestation scale scored by 2 independent, blinded observers. Results Participants in the treatment group with vibration analgesia were 0.47 times less likely (95% confidence interval, 0.24–0.94; P = 0.03) to experience any pain than the control group. The median summative pain score in the treatment group was significantly less than that of the control group [1 (interquartile range, 1–2) vs 2 (interquartile range, 2–4); P < 0.01] among participants who experienced any pain. Agreement between the 2 blinded observers regarding pain scores was excellent with κ w = 0.82 (P < 0.001). Age, sex, body mass index, needle location or size, and medication doses did not differ significantly between the 2 groups. Conclusion Vibration analgesia is an effective, low-risk modality that reduces the pain of intravenous propofol injection in general anesthesia.

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Section: Discussionmentioning

confidence: 75%

mentioning

confidence: 99%

The Effect of Vibration on Pain During Intravenous Injection of Propofol

Hwang¹,

Nash²,

Yedlin

et al. 2021

Ann Plast Surg

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“…The mechanism of rocuronium-induced injection pain is still unclear and may be related to several factors [ 8 ]. The stimulation on chemoreceptors by the pH and osmotic pressure of the rocuronium solution can cause painful sensations at the injection site [ 9 ]. Kanazawa et al [ 10 ] discovered that diluted rocuronium is effective in alleviating injection pain when administered through dorsal digital veins, which indicated that rocuronium-induced injection pain might be related to the intensity of drug stimulation on the vessels’ wall.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, rocuronium may permeate through the vascular wall to surrounding tissues, promoting histamine to be released, and creating local swelling and pain, as well as stimulating local nerve terminals to induce signal transduction, and generating central pain perception [ 11 ]. The activation of the kinin cascade system, which leads to the release of intermediate mediators such as bradykinin, may also be linked to the pain and arm withdrawal generated by rocuronium injection [ 9 ]. In addition, rocuronium is stored at a temperature of 2–8 °C.…”

Section: Discussionmentioning

confidence: 99%

Median Effective Dose of Remifentanil for the Prevention of Pain Caused by the Injection of Rocuronium: An Age-Stratified Study

Yan

et al. 2023

Pain Ther

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Introduction Rocuronium intravenous pain is common in induction of general anesthesia. The aim of our study was to determine the median effective dose (ED 50 ) of prophylactic intravenous remifentanil for the prevention of rocuronium injection pain and to explore the effect of age on the ED 50 . Methods Eighty-nine adult patients undergoing elective general anesthesia, ASA I or II, regardless of gender or weight, were stratified according to age: group R1 18–44 years, group R2 45–59 years, and group R3 60–80 years. The initial dose of prophylactic remifentanil before rocuronium injection was set at 1 μg/kg lean body weight (LBW). The remifentanil doses were adjusted according to the degree of injection pain using the Dixon sequential method, with a ratio of 1.1 between adjacent doses. Injection pain was graded, and the occurrence of injection pain and adverse reactions were recorded. The ED 50 and 95% confidence intervals (CIs) of remifentanil were calculated using the Dixon–Massey formula. Patients were asked whether they recalled feeling any injection pain in the post-anesthesia care unit (PACU). Results The ED 50 (95% CIs) of prophylactic remifentanil for the prevention of rocuronium injection pain were 1.266 μg/kg (1.186–1.351 μg/kg), 1.188 μg/kg (1.065–1.324 μg/kg), and 1.070 μg/kg (1.014–1.129 μg/kg) LBW in group R1, group R2, and group R3, respectively. No adverse reactions to remifentanil occurred in any group. In PACU, 84.6, 86.7, and 85.7% of patients who experienced injection pain had memories of the pain in group R1, group R2, and group R3, respectively. Conclusions Prophylactic intravenous remifentanil can prevent rocuronium injection pain, and its ED 50 decreases with age, with 1.266 μg/kg (18–44 years), 1.188 μg/kg (45–59 years), and 1.070 μg/kg LBW (60–80 years), respectively. Trial Registration ClinicalTrials.gov: NCT05217238 (registration date 18 Dec 2021).

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A subclinical dose of esketamine pretreatment for propofol and rocuronium injection pain

Chen

et al. 2022

Asian Journal of Surgery

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Gabapentin pretreatment for propofol and rocuronium injection pain: A randomized, double-blind, placebo-controlled study

Cited by 5 publications

References 0 publications

The Effect of Vibration on Pain During Intravenous Injection of Propofol

The Effect of Vibration on Pain During Intravenous Injection of Propofol

Median Effective Dose of Remifentanil for the Prevention of Pain Caused by the Injection of Rocuronium: An Age-Stratified Study

A subclinical dose of esketamine pretreatment for propofol and rocuronium injection pain

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