Paracetamol, Ondansetron, Granisetron, Magnesium Sulfate and Lidocaine and Reduced Propofol Injection Pain

Abstract

Background:Propofol is a most widely used intravenous anesthetic drug. One of its most common complications is the pain upon injection; therefore, different methods, with various effects, have been proposed in order to alleviate the pain.Objectives:This study investigates the effects of paracetamol, ondansetron, granisetron, magnesium sulfate and lidocaine drugs on reducing the pain of propofol injection during anesthetic induction. Also, the hemodynamic changes will be analyzed.Patients and Methods:This is an interventional study containing 336 patients underwent elective orthopedic surgeries in Educational Hospitals of Mashhad University, using systematic sampling, the patients were divided into six groups. A 20-gauge needle was inserted into a venous vessel in the back of the hand and 100 cc of Ringer serum was injected into the vein, which was applied proximal to the injection site. Afterwards, paracetamol 2 mg/kg (group p), magnesium sulfate 2 mmol (group M), ondansetron 4 mg (group O), granisetron 2 mg (group G), lidocaine 40 mg (group L) and 5 cc saline (group S) were injected into the vessel, after 60 seconds, the tourniquet was opened. One quarter of the total dose of propofol (2.5 mg/kg) was injected with a flow rate of 4 mg/sec and then the injection pain was measured. Finally, the fentanyl (2 µg/kg), atracurium 0.5 mg/kg, and the remaining dose of propofol were injected and the vital signs were recorded before the administration of propofol and 1, 3, 5 and 10 minutes after the propofol injection.Results:The six groups did not significantly differ, regarding their gender, weight or age. Propofol injection pain was less in L and G groups, in comparison with the others (P ≤ 0.001). By analyzing the hemodynamic changes, it was observed that the least amount of change in mean arterial pressure was observed in the paracetamol group.Conclusions:The reduction of propofol injection pain was observed by using medications (in comparison with normal saline), but it was more significant in groups G and L. Moreover, Hypotension was higher in groups S and G and it was lessened in group P.

Ondansetron Versus Lidocaine 2% for the Prevention of Propofol Injection Induced Pain.

“…The effects of lidocaine and granisetron are similar (69.64%) and higher than the other groups. The effects of magnesium sulfate (51.78%), ondansetron (39.28%) and paracetamol (28.57%) are less than the lidocaine and granisetron, therefore, these results were not matched with our results [30].…”

Lidocaine Versus Ketamine Pretreatment on Propofol Injection Pain

“…They got significant decrease in pain with 20mg lidocaine on propofol injection is much less than the lidocaine dose that we used, and this discrepancy may be because they mixed propofol with lidocaine and their research done only on female gender [19]. Ali pour M et al, studied 336 patients compared many drugs and lidocaine to placebo on reducing the pain of propofol injection, the result showed that lidocaine is more significantly reduces pain on propofol injection than the other groups [ 20]. MGupto, S Mishro et al, studied a 100 female patients for evaluation lidocaine, pethidine, dexamethasone compared to placebo group results to decrease the incidence of propofol pain showed that all pretreatment groups the incidence of propofol injection pain reduces considerably more than placebo [9].…”

Pretreatment with Magnesium Sulfate to Alleviate Pain on Propofol Injection: A Prospective Randomized Double Blind Study

“…In another study, titled "Paracetamol, Ondansetron, Granisetron, Magnesium Sulfate and Lidocaine and Reduced Propofol injection pain" by Alipour et al 18 showed pain observed with Paracetamol in 72% patients, Ondansetron61%, granesetron30% Magnesium 48% and Lidocaine 30% patients.…”