Efficacy of ondansetron for the prevention of propofol injection pain: a meta-analysis

Abstract

AimThis review was performed to investigate the effect of ondansetron on the prevention of propofol injection pain.MethodsPubMed, Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched for randomized controlled trials (RCTs) of ondansetron in preventing the pain on injection of propofol. Then, RevMan 5.2 was adopted to conduct a meta-analysis on propofol injection pain.ResultsTen RCTs, totaling 782 patients, were included in this analysis. The meta-analysis showed that: 1) compared with the control group, the ondansetron group was related to a decreasing incidence of propofol injection pain, and it was statistically significant (risk ratio [RR] = 0.41, 95% confidence interval [CI, 0.34, 0.49], P < 0.00001); 2) compared with the incidence of propofol injection pain in the lidocaine group, there was no difference and no statistical significance (RR = 1.28, 95% CI [0.85, 1.93], P = 0.25); 3) no statistically significant differences were found between the ondansetron and magnesium sulfate groups in the incidence of propofol injection pain (RR = 1.20, 95% CI [0.87, 1.66], P = 0.27); and 4) the incidence of ondansetron group igniting moderate pain (RR = 0.37, 95% CI [0.26, 0.52], P < 0.00001) and severe pain (RR = 0.27, 95% CI [0.17, 0.43] P < 0.00001) was less likely to occur during the injection of propofol compared with the control group, but there was no difference between the ondansetron and control groups in the incidence of mild propofol injection pain (RR = 0.83, 95% CI [0.63, 1.10], P = 0.20).ConclusionOndansetron can effectively prevent propofol injection pain, and the effect is similar to that of magnesium sulfate and lidocaine.

Effect of Preemptive Intravenous Ibuprofen on propofol Injection Pain

“…Pei et al [23] in a review of PubMed, Cochrane Library and China National Knowledge Infrastructure (CNKI) researched the efficacy of ondansetron and reported that ondansetron had similar efficacy to lidocaine in reducing propofol injection pain. In recent years, there are studies in the literature on whether methods like acupuncture, heating the intravenous entry point and pretreatment with ketamine are effective in preventing propofol injection pain [12,24].…”

Comparasion between effects of lidocaine, magnesium- sulfate and ondansetron on propofol injection pain (lidocaine, magnesium- sulfate, ondasentrone and propofol application)

“…Osim za opštu anesteziju, on ima široku primenu i za sedaciju 1 . Koristi se u adultnoj i pedijatrijskoj populaciji.…”

“…Mogući mehanizam nastanka osećaja bola izazvanog propofolom je aktivacija kalikrein-kinin sistema i oslobađanje bradikinina, što rezultira venskom dilatacijom i povećanjem permeabiliteta, a sa tim i kontaktom između vodene faze propofola i slobodnih nervnih završetaka 1,20,21 . Međutim, nedavne studije pokazuju da u poređe-nju sa fiziološkim rastvorom, propofol ne podiže koncentraciju bradikinina u plazmi 1,22,23 . Lidokain je primarno lokalni anestetik, koji je pronašao i sistemsku primenu 20,24 .…”

Pain during intravenous Propofol injection and its prevention in the pediatric population. A randomized controlled trial.

“…5 The incidence rate of propofol injection pain is between 32% and 48% and despite efforts by anesthesiologists, it cannot be completely prevented. 6 The available form of DOI: 10.29309/TPMJ/2020.27. 1 propofol is made by mixing it with soybean oil emulsion (1% of propofol in 10% of soybean oil emulsion).…”