Ephedrine Reduces the Pain from Propofol Injection

Cheong, Mi Ae; Kim, Kyo Sang; Choi, Won Jun

doi:10.1097/00000539-200211000-00035

Cited by 59 publications

(61 citation statements)

References 13 publications

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“…Ephedrine an α and β receptor agonist attenuates pain by decreasing release of bradykinin from vascular endothelium; it also releases noradrenaline endogenously, thus producing vasoconstriction. [23,24] Non-steroidal anti-inflammatory drugs like Ketorolac reduce prostaglandin synthesis; they were given as pretreatment, but failed to reduce the propofol injection pain. [25] Ondansetron has multifaceted actions as sodium channel blocker, 5-HT3 receptor antagonist and a μ-opioid agonist; it may be potentially useful to alleviate pain of propofol in the doses used to induce antiemesis.…”

Section: Discussion 21 Different Formulations Of Propofol Derived Fomentioning

confidence: 99%

Propofol – A Gallery of Different Formulations and Methods to Alleviate Pain on Injection

Gadre¹

2017

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Propofol is a popular intravenous (IV) anaesthetic agent both for induction and maintenance. The initial formulations were potent lipid emulsions; efforts to overcome their drawbacks have altered propofol preparation over the decades. Propofol soybean emulsion has been largely acceptable because it is composed of substances endogenous to the body. Pain on injection, allergic reactions, contamination and hyperlipidaemia are the risk factors that occur frequently. Pain on injection is still an unsolved clinical problem during anaesthesia. Various pre-treatment and induction techniques that have been investigated to minimize the incidence of pain have been discussed here and will find the interest of the readers.

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Section: Discussion 21 Different Formulations Of Propofol Derived Fomentioning

confidence: 99%

Propofol – A Gallery of Different Formulations and Methods to Alleviate Pain on Injection

Gadre¹

2017

jmscr

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“…Propofolün soğuk uygulanması (4°C), ısıtılarak (37°C) uygulanması, propofol infüzyonunun seyreltilmesi, taşıyıcı infüzyon sıvısının hızının değiştirilmesi (4) , lidokain, nonsteroidal antiinflamatuvar ilaçlar (5,6) , granisetron (1) , metoklopromid (7) , opioidler (8) , hidrokortizon (9) , deksmedetomidin (10) , magnezyum sülfat (11) , efedrin (12) ve kısa etkili beta-bloker (13) ile öntedavi, oral klonidin verilmesi bunlardan bazılarıdır. Bu uygulamaların bir kısmı etkisiz kalırken bir kısmı da ağrıyı tamamen engelleyememiş ancak, ağrı insidansını ve yoğunluğunu azaltmıştır.…”

Section: Discussionunclassified

Effect of the site of intravascular cannula on injection pain of propofol

Şahinkaya¹,

Akpınar²,

Tekgül³

et al. 2016

Terh

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ÖZAmaç: Propofol hızlı bilinç kaybı ve çabuk derlenme özellikleri nedeniyle genel anestezi indüksiyonunda sıklıkla tercih edilen bir intravenöz sedatif ve hipnotik ajandır. Ancak intravenöz enjeksiyon sırasında yanıcı ağrıya neden olmaktadır. Propofol enjeksiyon ağrısı insidansının %28 ile %90 arasında değiştiği rapor edilmiştir. Bu çalışma ile genel anestezi indüksiyonunda kullanılan propofolün farklı damar yollarından verilmesinin hastada oluşturacağı ağrı ve hasta konforu üzerine etkisinin gözlemlenmesi amaçlanmıştır. Yöntem: Çalışmaya 107 hasta dâhil edildi. Grup 1 (56 hasta)'deki hastalara küçük çaplı venden (el sırtı) ve Grup 2 (51 hasta)'deki hastalara geniş çaplı venden (antekubital) propofol enjekte edildi. Enjeksiyon ağrısı 4 noktalı sözel ağrı derecelendirme skalası ve Wong-Baker yüz skalası ile ölçüldü. Bulgular: Grup 2'de ağrı skorlarında ve ağrı insidansında istatistiksel olarak anlamlı bir azalma görüldü (p<0.001). Sonuç: Sonuç olarak, propofolün büyük çaplı bir vene yerleştirilen intravasküler kanülden uygulanması enjeksiyon ağrısını azaltmada etkilidir. Böylelikle hastalara farmakolojik bir ajan verilmesine gerek kalmamaktadır. Anahtar kelimeler: Antekubital bölge, enjeksiyon ağrısı, propofol ABSTRACTObjective: Propofol is a sedative and hypnothic agent that is mostly used during induction of general anesthesia due to its rapid loss of consciousness and recovery. However it causes pain during intravenous injection. It's reported that incidence of injection site pain of propofol ranges from 28% to 90%. However during intravenous injection it causes burning pain. Methods: 107 patients were included in the study. Propofol was given through a small vein (dorsum of hand) in Group 1 (n=56) patients and through a large vein (antecubital) in Group 2 (n=51) patients. Injection pain was measured using 4 point verbal rating scale and Wong-Baker face scale. Results: It is found that there is a statistically significant decrease in pain scores and incidence in Group 2 (p<0.001). Conclusion: As a result, injection of propofol through an intravascular cannula placed in a large vein is effective for reducing injection site pain. So that, patients have no need for another medication.

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“…[2,4,[14][15][16][17] Hovewer, even in patients who received most popular lidocaine treatment, the incidence of pain has been reported as frequent as 32%-48%. [15] Propofol is an excellent anesthetic that belongs to the group of phenols, which can irritate the skin, mucous membrane and venous intima. It may activate the kallikrein-kinin system and release bradykinin, thereby producing venous dilatation, and hyperpermeability, which increases the contact between the aquaeous phase of propofol and free nerve endings resulting pain on injection.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment with a very low dose of intravenous esmolol reduces propofol injection pain.

E¹,

Titiz²,

Akpek³

et al. 2013

Agri

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SummaryObjectives: Propofol causes considerable pain upon injection, although different methods and propofol formulations have been used to decrease this pain. We aimed to investigate the effect of i.v. esmolol pretreatment on propofol injection pain.Methods: Ninety ASA I-II patients undergoing elective surgery under general anesthesia were randomly assigned into three groups of thirty each. A 20 G cannula was inserted into the dorsum of the nondependent hand. After venous occlusion for one minute, groups E, L and S were pretreated with 5 mg/ml (total 2 ml) esmolol, 40 mg lidocaine and 2 ml saline i.v. respectively. After release of venous occlusion, one fourth of the total propofol dose was administered at a rate of 0.5 ml/sec. During the injection of both pretreatment solution and propofol, patient pain was assessed by using 4 point scale. Heart rate and noninvasive arterial blood pressure values were recorded before induction, just after entubation and five minutes after entubation. Results:Demographic values were similar among groups. Incidence of pain on injection of propofol in the control, esmolol and lidocaine groups was 90%, 33.3%, 50% respectively (p<0.05). Heart rate, systolic arterial pressure, and diastolic arterial pressure values were not different between the groups.Conclusion: Pretreatment with low dose esmolol i.v. seems to be effective in attenuating pain during propofol injection.

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Ephedrine Reduces the Pain from Propofol Injection

Abstract: Propofol is a widely used IV anesthetic for the induction of anesthesia, but it often causes local pain when administered into peripheral veins. A small dose of ephedrine reduces the incidence and intensity of the pain without significant adverse hemodynamic effects during induction.

Cited by 59 publications

References 13 publications

Propofol – A Gallery of Different Formulations and Methods to Alleviate Pain on Injection

Propofol – A Gallery of Different Formulations and Methods to Alleviate Pain on Injection

Effect of the site of intravascular cannula on injection pain of propofol

Pretreatment with a very low dose of intravenous esmolol reduces propofol injection pain.

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