Pain on injection of propofol: a comparison of methylene blue and lidocaine

Salman, A. Ebru; Salman, M. A.; Saricaoglu, Fatma; Akıncı, Seda Banu; Aypar, Ülkü

doi:10.1016/j.jclinane.2010.09.008

Cited by 26 publications

(21 citation statements)

References 33 publications

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“…The 73% pain incidence in this study was lower than the 90% in the 0.9% sodium chloride group of another study that evaluated the effect of lidocaine and methylene blue on propofol injection pain [28]. In that study, propofol injection pain was detected in 40% of the methylene blue group.…”

Section: Discussioncontrasting

confidence: 53%

Hyoscine N-Butylbromide for Preventing Propofol Injection Pain: A Randomized, Placebo-Controlled and Double-Blind Study

Sargın¹,

Uluer²,

Aydoğan³

2018

Med Princ Pract

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Objective: In this study, the aim was to investigate the effect of hyoscine N-butylbromide (HnBB) pretreatment on pain during propofol injection. Subjects and Methods: In this prospective, randomized, placebo-controlled and double-blind trial, 60 patients scheduled to undergo routine outpatient surgery under general anesthesia were randomly allocated to 2 groups, the HnBB (n = 30) and sodium chloride (n = 30) groups. Twenty seconds after the injection of 20 mg HnBB or 0.9 % sodium chloride, a 50-mg dose of propofol was injected in 2–3 s. Ten seconds later, the pain intensity was assessed using a 4-point scale: no pain (0), mild (1), moderate (2), and severe (3) pain. The Student t test was used for the analysis of parametric data and the Pearson χ² test for categorical data. Results: The occurrence of pain in the HnBB group (43.3%) was significantly lower than the control group (73.3%) (p < 0.018). Of the 30 patients in each group, 10 in the control group and 3 in the HnBB group experienced severe pain (p = 0.001). Conclusions: Pretreatment with 20 mg HnBB significantly reduced propofol injection pain compared to placebo.

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Section: Discussioncontrasting

confidence: 53%

Hyoscine N-Butylbromide for Preventing Propofol Injection Pain: A Randomized, Placebo-Controlled and Double-Blind Study

Sargın¹,

Uluer²,

Aydoğan³

2018

Med Princ Pract

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“…Furthermore, drugs such as dexamethasone (with or without lignocaine),[53] antihistamines such as diphenhydramine,[54] magnesium sulfate,[55] ephedrine,[51] and methylene blue[56] have been used with some success.…”

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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“…On the basis of previously published data, [1] we estimated the incidence of pain during propofol injection in the placebo group to be around 80%. A 40% difference (80%–40%) between placebo group and treatment groups would be considered of clinical significance.…”

Section: Methodsmentioning

confidence: 99%

“…However, pain during injection of propofol can occur in up to 80% of patients, which can be very stressful to patients. [1–3] Many methods including cooling or diluting the propofol solution or the concomitant use of drugs such as methylene blue, pregabalin, or magnesium sulfate have been used to reduce this pain. [1–3] However, these treatments cannot alleviate the pain, which remains a challenge.…”

Section: Introductionmentioning

confidence: 99%

“…[1–3] Many methods including cooling or diluting the propofol solution or the concomitant use of drugs such as methylene blue, pregabalin, or magnesium sulfate have been used to reduce this pain. [1–3] However, these treatments cannot alleviate the pain, which remains a challenge. It was reported that aqueous free propofol could be responsible for injection pain.…”

Section: Introductionmentioning

confidence: 99%

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Comparative evaluation of the effect of remifentanil and 2 different doses of esmolol on pain during propofol injection

et al. 2017

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Background: Propofol is associated with pain during injection, which is stressful to patients. The present study was designed to investigate the analgesic effect of pretreatment with remifentanil and esmolol in minimizing propofol injection pain, compared with placebo.Methods: In a randomized, double-blind, prospective trial, 120 patients, scheduled for elective dental surgery under general anesthesia, were randomized to 1 of the 4 treatment arms (n = 30 each) receiving normal saline, remifentanil 0.35 mg/kg, esmolol 0.5 mg/kg, and 1 mg/kg before administration of propofol. During injection of 1% propofol 0.5 mg/kg, pain was evaluated by a 4-point score (0 = none, 1 = mild, 2 = moderate, 3 = severe). Any adverse effects such as hypotension and bradycardia were recorded during the perioperative periods.Results: In all, 120 patients completed this study. There were no significant differences in terms of demographic data. The incidence of pain on injection of propofol was 11 (36.7%) with remifentanil 0.35 mg/kg, 12 (40%) with esmolol 0.5 mg/kg, and 11 (36.7%) with esmolol 1 mg/kg, compared with 25 (83.3%) with normal saline (respectively, P < 0.05). There were no significant differences in the incidence of pain between groups with remifentanil 0.35 mg/kg, and esmolol 0.5 mg/kg and 1 mg/kg. There were no emergence reactions such as hypotension and bradycardia in all groups.Conclusions: Pretreatment with esmolol 0.5 mg/kg and 1 mg/kg and remifentanil 0.35 mg/kg equally decreased pain during propofol injection.Abbreviations: LCT = long-chain triglyceride, MCT = medium-chain triglyceride, NMDA = N-methyl-d-aspartate.

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Pain on injection of propofol: a comparison of methylene blue and lidocaine

Cited by 26 publications

References 33 publications

Hyoscine N-Butylbromide for Preventing Propofol Injection Pain: A Randomized, Placebo-Controlled and Double-Blind Study

Hyoscine N-Butylbromide for Preventing Propofol Injection Pain: A Randomized, Placebo-Controlled and Double-Blind Study

Pain on propofol injection: Causes and remedies

Comparative evaluation of the effect of remifentanil and 2 different doses of esmolol on pain during propofol injection

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