The effects of alfentanil or remifentanil pretreatment on propofol injection pain

İyilikçi, Leyla; Balkan, Bahar Kuvaki; Gökel, Erol; Günerli, Ali; Ellıdokuz, Hülya

doi:10.1016/j.jclinane.2004.01.005

Cited by 43 publications

(41 citation statements)

References 19 publications

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“…[42] Fletcher et al . in 1994 had also shown that alfentanil in the dose of 1 mg when injected 15 s before the injection of propofol, reduced POPI significantly.…”

Section: Remedies For Pain On Propofol Injectionmentioning

confidence: 99%

Pain on propofol injection: Causes and remedies

DeSousa

2016

Indian J Pharmacol

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Pain on propofol injection (POPI) is a minor problem that all anesthetists face every day. Introduction of several new formulations and hundreds of clinical trials have failed to find its remedy with just one intervention in all patients. This article highlights the causes of POPI and interventions that are used to eliminate this pain in current practice. Relevant articles from Medline and Embase databases were searched and included in this descriptive review with the following conclusions: (1) POPI is due to irritation of venous adventitia leading to release of mediators such as kininogen from kinin cascade. (2) When two or more drugs or measures are used, the incidence of POPI decreases considerably. Hence, the approach to eliminating POPI should be multimodal. (3) Any regimen that includes a drug having local anesthetic effect combined with central sedative/analgesic and rapid injection into a large vein should definitely reduce the risk of POPI to negligible levels.

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“…[42] Fletcher et al . in 1994 had also shown that alfentanil in the dose of 1 mg when injected 15 s before the injection of propofol, reduced POPI significantly.…”

Section: Remedies For Pain On Propofol Injectionmentioning

confidence: 99%

Pain on propofol injection: Causes and remedies

DeSousa

2016

Indian J Pharmacol

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“…In previous studies, 15 μg/kg∼1 mg alfentanil was used for propofol-induced pain; however, this increases the risk of hypoxemia during FB sedation. [ 10 27 ] …”

Section: Discussionmentioning

confidence: 99%

“…[ 2–7 ] Alfentanil and propofol have the properties of fast onset and quick recovery, and they have been proven to be ideal for FB sedation providing good bronchoscopist satisfaction and patient tolerance. [ 8 9 ] It has also been reported that alfentanil can reduce the injection pain related to propofol administration [10] . However, the risk of cardiopulmonary depression is a critical concern because of the pharmacokinetic synergy of these drugs to suppress respiratory drive and attenuate sympathetic effects.…”

Section: Introductionmentioning

confidence: 99%

The safety and efficacy of alfentanil-based induction in bronchoscopy sedation

et al. 2016

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Background:Alfentanil in combination with propofol produces a synergistic sedative effect in patients undergoing flexible bronchoscopy (FB). However, the use of this combination is controversial due to the risk of cardiopulmonary depression. The aim of this study was to evaluate the proper induction regimen of alfentanil in propofol target-controlled infusion for FB sedation.Methods:One hundred seventy-three patients were assigned randomly into 5 regimens: Group 1 and 2, alfentanil 2.5 and 5 μg/kg, respectively, immediately before propofol administration; Group 3 and 4, alfentanil 2.5 and 5 μg/kg, respectively, 2 minutes before propofol administration; and Group 5, propofol administration alone to achieve the observer assessment of alertness and sedation scale 3∼2. The bronchoscopists, physicians in charge of sedation, and patients were blind to the regimens. Adverse events, drug dose, induction, procedure and recovery time, cough severity, and propofol injection related pain were recorded.Results:The patients in groups 2 and 4 required a lower dose of propofol (P = 0.031 and 0.019, respectively) and shorter time (P = 0.035 and 0.010) than group 5 for induction. Patients in group 2 experienced more hypoxemia than those in group 5 during induction (P = 0.031). The physician in charge of sedation scored a lower severity of cough in the patients in group 4 than in groups 3 and 5. There were no differences in terms of propofol injection related pain among the groups.Conclusion:Alfentanil 5 μg/kg given immediately before propofol infusion cannot be recommended. Further study is required to define conclusions about alfentanil 2.5 and 5 μg/kg because of the low power rating of subgroup in the present study.

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“…Fentanyl, sufentanil and remifentanil appear to be a very titratable opioid providing profound intraoperative analgesia [28][29][30] . In the report by Han 15 , combination of a pretreatment with remifentanil and premixture of lidocaine and microemulsion propofol displayed effective function in reducing the incidence of pain on an injection of microemulsion propofol 31 .…”

Section: Comparison Of Anesthesia Effect Of Propofol Via Different Comentioning

confidence: 99%