Pre-treatment with intravenous granisetron to alleviate pain on propofol injection: A double-blind, randomized, controlled trial

Abstract

Background:Propofol is one of the widely used intravenous (i.v.) anaesthetics, although pain on injection still remains a considerable concern for the anaesthesiologists. A number of techniques has been tried to minimize propofol-induced pain with variable results. Recently, a 5-HT3 antagonist, ondansetron pre-treatment, has been shown to reduce propofol-induced pain. The aim of our randomized, placebo-controlled, double-blinded study was to determine whether pre-treatment with intravenous granisetron, which is routinely used in our practice for prophylaxis of post-operative nausea and vomiting, would reduce propofol-induced pain.Methods:Eighty-two women, aged 18–50 years, American society of Anaesthesiologist grading (ASA) I–II, scheduled for various surgeries under general anaesthesia were randomly assigned to one of the two groups. One group received 2 mL 0.9% sodium chloride while the other group received 2 mL granisetron (1 mg/mL), and were accompanied by manual venous occlusion for 1 min. Then, 2 mL propofol was injected through the same cannula. Patients were asked by a blinded investigator to score the pain on injection of propofol with a four-point scale: 0=no pain, 1=mild pain, 2=moderate pain, 3=severe pain.Results:Twenty-four patients (60%) complained of pain in the group pre-treated with normal saline as compared with six (15%) in the group pre-treated with granisetron. Pain was reduced significantly in the granisetron group (P<0.05). Severity of pain was also lesser in the granisetron group compared with the placebo group (2.5% vs. 37.5%).Conclusion:We conclude that pre-treatment with granisetron along with venous occlusion for 1 min for prevention of propofol-induced pain was highly successful.

Comparative Study on the Effectiveness of Granisetron and Metoclopramide for Reducing Propofol Injection Pain

“…This was similar to the way the study conducted by to R.A. Johnson et al 1990 [19] , S.P. Ambesh et al 1999 [8] , Ahmed etal [71] .…”

A Clinical Study to Compare the Efficacy of Pretreatment with Granisetron and Lignocaine to Alleviate Pain on Propofol Injection

“…[14] The dose of granisetron used in our study was 2ml (1mg/ml) as this dose was considered to be effective as in previous study. [1] In our study, distribution of age ranged between 18-50 yrs with the mean age of lignocaine group being 38yrs and for granisetron group being 40 yrs. Majority of patients in both Licensed Under Creative Commons Attribution CC BY groups were males, 64% in lignocaine group and 52% in granisetron group.…”

“…Pain on injection of anaesthetic is an important cause of patient dissatisfaction and is a recognised adverse effect of propofol. [1] The reported incidence of pain on injection of propofol varies between 28% and 90% in adults if a vein on dorsum of the hand is used. [2] It is known to cause severe, sharp, stinging or burning pain on injection that can be distressing to the patient.…”

Pre-Treatment with Intravenous Granisetron to Alleviate Pain on Propofol Injection: A Double Blind Randomised Controlled Study Using Normal Saline as Control

“…Fewer patients in the granisetron group experienced severe pain (2.5% vs. 37.5%; P<0.05). (Ahmed A et al, 2012) 42 In a study by Ambesh et al on effect of ondensetron in injection of propofol, the overall incidence of pain in the saline group was 55%, compared with 25% in the ondensetron group (p=0.05). [Ambesh SP et al, 1999] 1 Singh DK et al, reported that granisetron reduced the incidence of propofol injection pain to 24% at 5 seconds, 24% at 10 seconds, 40% at 15 seconds and 40% at 20 seconds in comparison to the control group, whereas placebo had an incidence of 80% at 5 seconds, 84% at 10 seconds, 88% at 15 seconds and 88% at 20 seconds and showed statistical significance.…”