Background:Propofol causes a high incidence of pain during intravenous (IV) injection. The aim of this randomized, placebo-controlled, double-blinded study was to determine whether pre-treatment with IV ramosetron, used for prophylaxis of postoperative nausea and vomiting (PONV), would reduce propofol-induced pain as an equivalent to lidocaine.Materials and Methods:Hundred and twenty American Society of Anesthesiologists grade (ASA) I and II patients were randomly assigned into three groups (40 in each). Group N received 2 ml of 0.9% saline, Group L received 2 ml of lidocaine, and Group R received 2 ml of ramosetron. Mid forearm was occluded manually before injection and released after 1 min and then propofol was injected over 5 s. Patients were observed and questioned 15 s later if they had pain in the arm and pain was scored on a four-point scale: 0 = no pain, 1 = mild pain, 2 = moderate pain, and 3 = severe pain. Unpaired Student's t-test and chi-square test/Fisher’ exact test were used to analyze results.Results:The incidence of pain in groups N, L, and R were 65, 35, and 30%, respectively. Pain was reduced significantly in the groups L and R (P < 0.05). Two patients each in Groups L and R (5% each) had moderate and severe pain. This difference in pain was statistically insignificant, but when compared to Group N (25 and 30%, respectively) it was statistically significant.Conclusion:Pretreatment with ramosetron 0.3 mg and lidocaine 40 mg are equally effective in preventing pain from propofol injection.

BACKGROUND:Patients undergoing coronary artery bypass grafting are susceptible to haemodynamic labiality during anaesthesia induction. AIMS AND OBJECTIVE: To evaluate the hemodynamic effects of etomidate in comparison to that of propofol during induction of general anaesthesia. SETTINGS AND DESIGN: The study was conducted in the department of anaesthesia of a tertiary care medical college setting over a period of one year from October 2013 to October 2014 on patients undergoing elective coronary artery bypass surgery under general anaesthesia. MATERIAL AND METHODS: 40 adult patients who are aged 35-65 years belonging to American Society Anaesthesia grades 1 and 2 undergoing elective surgery under general anaesthesia, were divided randomly into two groups of 20 patients each. By using bispectral index of 50 as a goal for induction, group a patients were given intravenous propofol injection, and group B were given etomidate injection. STASTICAL ANALYSIS: Data is presented as mean and standard deviation. The statistical analysis was performed using SPSS 15.0, Stata 8.0, medicals 9.0.1 and Systat 11.0. A "p" value of less than 0.05 was taken as significant. RESULTS: Our results in both (P and E respectively) groups showed significant reduction in arterial pressure (30%-22%), SVRI (31%-23%), and LVSWI (38%-32%) after anaesthesia induction. However, the heart rate (3%-10%) and cardiac index did not change significantly. SVRI significantly increased in the etomidate group after intubation. CONCLUSION: Propofol can produce a larger reduction in contractility, arterial pressure, and after load when compared to etomidate as an induction agent in patients with coronary artery disease. Etomidate is less effective in preventing stress response to intubation.

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