Effects of a fentanyl-propofol mixture on propofol injection pain: a randomized clinical trial

Abstract

BackgroundPropofol injection pain is a common problem that can be very distressing for patients. We compared the effects of injection with saline followed by injection with a fentanyl-propofol mixture, injection with fentanyl followed by a propofol injection, and injection with saline followed by propofol alone on propofol injection pain.MethodsThe patients were assigned randomly to one of three groups. A rubber tourniquet was placed on the forearm to produce venous occlusion for 1 min. Before anesthesia induction, group C (control, n = 50) and group M (fentanylpropofol mixture, n = 50) received 5 ml of isotonic saline, while group F (fentanyl, n = 50) received 2 µg/kg of fentanyl. After the tourniquet was released, groups C and F received 5 ml of propofol and group M received 5 ml of a mixture containing 20 ml of propofol and 4 ml of fentanyl. At 10 s after the study drugs were given, a standard question about the comfort of the injection was asked of the patient. We used a verbal rating scale to evaluate propofol injection pain. Statistical analyses were performed with Student's t-tests and Fisher's exact tests; P < 0.05 was considered to indicate statistical significance.ResultsThe demographic data were similar among the groups. In group M, the number of patients reporting propofol injection pain was significantly lower than in groups F and C (both P < 0.001). No patient in group F or M experienced severe pain, whereas 24 patients (48%) had severe pain in group C (both P < 0.001).ConclusionsThis study shows that a fentanyl-propofol mixture was more effective than fentanyl pretreatment or a placebo in preventing propofol injection pain.

Comparison and Evaluation of Propofol Injection Pain with Two Different Doses of Fentanyl in Fentanyl-Propofol Mixture

“…Nurcan Kizilcik, et al (27) reported that fentanyl mixed with propofol reduced injection pain significantly compared with the control and fentanyl pretreatment groups which goes with our study and in addition, our study shows no difference between the two doses of fentanyl when mixed with propofol.…”

Comparison of simultaneous and sequential administration of fentanyl–propofol for surgical abortion: a randomized single-blinded controlled trial

“…FC pretreatment alleviates pain during PLE injection (Ahmad et al 2008). FC-PLE mixture was more effective than FC pretreatment or a placebo in preventing PLE injection pain (Kizilcik et al 2015). Compared with the traditional sequential administration, mixing PLE and FC through simultaneous administration induces low incidence of pain at the injection site, indicating that such mixing method does not cause leakage of higher amount of free propofol compared with sequential administration.…”

Premedication with parecoxib sodium for reduction of propofol injection pain: a randomized placebo-controlled trial

“…However, pain from the injection is a common problem [11]. The incidence of injection pain has been shown to vary between 28 and 90% which might be severe [12,13] A number of approaches have been proposed to lessen the injection pain such as injection of propofol at an antecubital fossa, fast injection [14] and pretreatment with lidocaine [15], opioids [16], or non-steroidal anti-in ammatory drugs (NSAIDs) [17]. The effective technique is a combination of lidocaine pretreatment together with venous occlusion (a modi ed Bier's block) [13].…”