Pain on Injection of Propofol: Efficacy of  Paracetamol and Lidocaine

Khouadja, Hosni; Arnous, H.; Tarmiz, K.; Beletaifa, D.; Brahim, Afef Ben; Brahem, W.; Sakhri, J.; Jazia, K. Ben

doi:10.4236/ojanes.2014.44013

“…Canbay et al [15] showed that the incidence of propofol injection pain was 64% in the control group and 22% in the intravenous paracetamol pretreatment group. Khouadja et al [31] also showed similar results, 85% in the control group and 36.6% in the intravenous paracetamol group.…”

Section: Discussionmentioning

confidence: 54%

Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

Nimmaanrat

¹

,

Jongjidpranitarn

²

,

Prathep

³

et al. 2019

Preprint

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Background: To compare the effect of premedication with 2 different doses of oral paracetamol to prevent pain at propofol intravenous injection. Methods: We conducted a double-blind randomized controlled trial in which patients scheduled for induction of general anesthesia with intravenous propofol received either a placebo, 500 mg or 1000 mg of oral paracetamol (P500 and P1000, respectively) 1 hr prior to induction. Two mg/kg of propofol was injected at a rate of 600 ml/hr. After 1/4 of the full dose had been injected, the syringe pump was paused, and patients were asked to rate pain at the injection site using a verbal numerical rating score (VNRS) from 0-10. Results: Three hundred and twenty-four patients were included. Pain intensity was lower in both P500 and P1000 groups (median VNRS [interquartile range] = 2 [0-3] and 4 [2-5], respectively) than in the placebo group (8 [7-10]; P<0.001)*. The rate of pain was lower in the P1000 group (70.4%) than in both the P500 and the placebo group (86.1% and 99.1%, respectively; P<0.001)*. The respective rates of mild (VNRS 1-3), moderate (VNRS 4-6) and severe pain (VNRS 7-10) were 47.2, 23.2 and 0% in the P1000 group, 28.7, 50 and 7.4% in the P500 group, and 0, 22.2 and 76.9% in the placebo group (P<0.001* for between group comparisons). Tolerance was similar in the 3 groups. Conclusions: A premedication with oral paracetamol can dose-dependently reduce pain at propofol intravenous injection. To avoid this common uncomfortable concern for the patients, this well-tolerated, available and cheap treatment appears as an option to be implemented in the current practice.

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“…Canbay et al [15] showed that the incidence of propofol injection pain was 64% in the control group and 22% in the intravenous paracetamol pretreatment group. Khouadja et al [27] also showed similar results, 85% in the control group and 36.6% in the intravenous paracetamol group.…”

Section: Discussionmentioning

confidence: 54%

“…In our study, the overall incidence of pain during propofol injection was higher than other studies. The previous 3 studies [15,27,28] used intravenous paracetamol, not oral tablet as we did. Oral form of paracetamol exerts different pharmacokinetics and pharmacodynamics in comparison to intravenous form.…”

Section: Discussionmentioning

confidence: 96%

Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

Nimmaanrat

¹

,

Jongjidpranitarn

²

,

Prathep

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background To compare premedication with 2 doses of oral paracetamol on the incidence and severity of propofol injection pain. Methods The 324 patients (18-65 years old) were randomly allocated into 3 groups. The groups Pb, P500 and P1000, participants were premedicated 1 hour prior to transferal to the operation with oral placebo, 500 or 1000 mg of paracetamol, respectively. Propofol (2 mg/kg) was injected at a rate of 600 ml/hr. After 1/4 of the calculated dose, the syringe pump was temporarily paused, and patients were asked to rate pain at the injection site using a verbal numerical rating score (VNRS) from 0-10. Results The incidence of pain was less in the P1000 group (70.4%) compared with the P500 (86.1%) and the Pb groups (99.1%) (P<0.001). Same as the median VNRS, 2 (0-3), 4 (2-5), and 8 (7-10) (P<0.001), respectively. The incidences of mild (VNRS of 1-3), moderate (VNRS of 4-6) and severe pain (VNRS of 7-10) were also in the same manner, 47.2%, 23.2%, and 0% (P1000), 28.7%, 50%, and 7.4% (P500) and 0%, 22.2%, and 76.9% (Pb) (P<0.001). No significant complications were found in any group. Conclusions Premedication with oral paracetamol, on a dose-dependent basis, can reduce propofol injection pain without causing any complications. As propofol injection pain is common and remains a concern for the comfort of the patients, and oral paracetamol is well-tolerated, available and economic, the results of this study provide the basis for continuing or changing practice with a positive impact on patient care.

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“…Khouadja et al . [31] performed a double-blinded RCT in 180 patients and also showed similar results, 85 % in the control group and 36.6% in the intravenous paracetamol group. Our results revealed that premedication with oral paracetamol reduced the incidence and severity of propofol injection pain.…”

Section: Discussionmentioning

confidence: 61%

Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

Nimmaanrat

¹

,

Jongjidpranitarn

²

,

Prathep

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background: To compare the effect of premedication with 2 different doses of oral paracetamol to prevent pain at propofol intravenous injection. Methods: We conducted a double-blind randomized controlled trial in which patients scheduled for induction of general anesthesia with intravenous propofol received either a placebo, 500 mg or 1000 mg of oral paracetamol (P500 and P1000, respectively) 1 hr prior to induction. Two mg/kg of propofol was injected at a rate of 600 ml/hr. After 1/4 of the full dose had been injected, the syringe pump was paused, and patients were asked to rate pain at the injection site using a verbal numerical rating score (VNRS) from 0-10. Results: Three hundred and twenty-four patients were included. Pain intensity was lower in both P500 and P1000 groups (median VNRS [interquartile range] = 2 [0-3] and 4 [2-5], respectively) than in the placebo group (8 [7-10]; P<0.001)*. The rate of pain was lower in the P1000 group (70.4%) than in both the P500 and the placebo group (86.1% and 99.1%, respectively; P<0.001)*. The respective rates of mild (VNRS 1-3), moderate (VNRS 4-6) and severe pain (VNRS 7-10) were 47.2, 23.2 and 0% in the P1000 group, 28.7, 50 and 7.4% in the P500 group, and 0, 22.2 and 76.9% in the placebo group (P<0.001* for between group comparisons). Tolerance was similar in the 3 groups. Conclusions: A premedication with oral paracetamol can dose-dependently reduce pain at propofol intravenous injection. To avoid this common uncomfortable concern for the patients, this well-tolerated, available and cheap treatment appears as an option to be implemented in the current practice.

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Pain on Injection of Propofol: Efficacy of Paracetamol and Lidocaine

Cited by 7 publications

References 27 publications

Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

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