Randomised Clinical Trial to Compare the Effect of Pretreatment of Ketamine and Lignocaine on Propofol Injection Pain

Abstract

BACKGROUND: Pain following injection of Propofol occurs in 28-90 % of patients. Various methods have been used to reduced the pain on intravenous injection of propofol namely administration of drugs like alfentanil, metoclopramide, pretreatment with intravenous lignocaine, pretreatment with intravenous ketamine etc., AIMS: In this study, we aimed to evaluate and compare the effect of pretreatment of ketamine and lignocaine on propofol injection pain. STUDY DESIGN: Randomised controlled study. METHODS: 120 patients of ASA grade I and II of both sexes between 18-60 years of age group scheduled for various elective surgical procedures, were randomly allocated into three groups of 40 each by envelope method using random number table. Patients of Group K (n=40) received ketamine 10 mgs (1 ml), Patients of Group L (n=40) received lignocaine 10 mgs (1 ml) and patients of Group S (n=40) received 0.9% normal saline (1 ml). In all these patients injection propofol (1%) was administered intravenously over a period of 5 seconds. 15 seconds later patients were asked about the presence of injection pain. RESULTS: Pain on Injection of propofol was assessed using the "Verbal categorical scoring system." Asked the patient to grade pain as no pain, mild pain or severe pain. They were score as 0, 1, or 2 respectively. The overall incidence of pain in control group (normal saline group) was 80%, Incidence of pain in ketamine group was 20 %, incidence of pain in lignocaine group was 30%. When compared between these two groups, ketamine significantly reduces pain as compared to lignocaine, which was not statistically significant (P>0.05). CONCLUSION: We conclude that both ketamine and lignocaine are effective in reducing the pain of intravenous injection of propofol, However ketamine is superior to lignocaine.