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

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background To compare the effect of premedication with two different doses of parecoxib sodium 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, 20 mg or 40 mg of parecoxib sodium (P20 and P40, respectively) 30min prior to induction. 2mg/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 to 10. Results Three hundred and twenty-four patients were included. Pain intensity was lower in both P20 and P40 groups (median VNRS [interquartile range] = 2 [0–3] and 4 [3–6], respectively) than in the placebo group (8 [7–10]; P &lt; 0.001)*. The rate of pain was lower in the P40 group (62.9%) than in both the P20 and the placebo group (87.0 and 98.2%, respectively; P &lt; 0.001)*. The respective rates of mild (VNRS 1–3), moderate (VNRS 4–6) and severe pain (VNRS 7–10) were 46.1, 22.3 and 0% in the P40 group, 29.7, 55.4 and 8.5% in the P20 group, and 0, 24.2 and 77.8% in the placebo group (P &lt; 0.001* for between group comparisons). Tolerance was similar in the 3 groups. Conclusions A premedication with parecoxib sodium 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.</jats:p>