Prevention of pain with the injection of microemulsion propofol: a comparison of a combination of lidocaine and ketamine with lidocaine or ketamine alone

Hwang, Insung; Noh, Jung Il; Kim, Soon Im; Kim, Mungyu; Park, Sunyoung; Kim, Sang Ho; Ok, Si Young

doi:10.4097/kjae.2010.59.4.233

Cited by 19 publications

(17 citation statements)

References 29 publications

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“…There exists a basic hypothesis about pain transmission that is sensitization of spinal cord by activating glutamate and aspartate in N-Methyl-D-aspartate (NMDA) receptors (7). Recognition of NMDA receptors and the roles they play in reducing the patients’ pain causes a novel evolution in consumption of such receptor antagonists like ketamine (8-10).…”

Section: Introductionmentioning

confidence: 99%

Analgesic Effect of Low Dose Subcutaneous Ketamine Administration Before and After Cesarean Section

Behaeen¹,

Soltanzadeh²,

Nesioonpour³

et al. 2014

Iran Red Crescent Med J

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Background:Pain is considered as an importantissue after cesarean section. Multimodal approach to post cesarean pain management may not only enhance analgesia but also reduce side effects after the surgery.Objectives:This study was aimed to evaluate the clinical efficacy of subcutaneous injection of low dose ketamine at the incision site to reduce cesarean section pain.Patients and Methods:Sixty patients, aged between 18 and 25 years old, scheduled for elective cesarean section, were enrolled to this double-blind randomized controlled trial study. Patients were divided into three groups of 20 patients each group one (k-pre) received 0.5 mg/kg ketamine before skin incision and normal saline after skin closure, group two (k-post) received normal saline before skin incision and 0.5 mg/kg ketamine after skin closure and group three (C) received normal saline before skin incision and after skin closure; subcutaneously at the incision site. The first analgesic request, the amount of analgesic and the pain intensity were evaluated for 24 hours.Results:The first time analgesic requested was longer and the amount of analgesic used during the first 24 hours was significantly lower in groups K-pre and K-post compared with group C (P < 0.05). Pain intensity was significantly lower at 2, 4, 6 and 12 hours in groups K-pre and K-post compared with group C (P < 0.05). Nevertheless, pain intensity was not significantly different at 18 and 24 hours in group C (P > 0.05). The first requested time, total used amount of analgesicand pain intensity were not meaningfully different in K-pre and K-post groups (P > 0.05).Conclusions:Patients who were given ketamine before or after cesarean section subcutaneously at incision site had lower pain intensity and less analgesic consumption than patients who were given placebo.

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Section: Introductionmentioning

confidence: 99%

Analgesic Effect of Low Dose Subcutaneous Ketamine Administration Before and After Cesarean Section

Behaeen¹,

Soltanzadeh²,

Nesioonpour³

et al. 2014

Iran Red Crescent Med J

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“…Although many studies1,2 have shown that effective analgesia reduces postoperative complications, pain is often overlooked and not adequately controlled 3. It has been shown that many excitatory substances are released by painful impulses which stimulate receptors to cause pain 3,4. The principal phenomenon in inflammatory pain transmission is sensitization of the spinal cord, with an active contribution from glutamate and aspartate amino acids at the N-methyl-dimethyl-aspartate (NMDA) receptor 4…”

Section: Introductionmentioning

confidence: 99%

Preincisional administration of intravenous or subcutaneous infiltration of low-dose ketamine suppresses postoperative pain after appendectomy

Honarmand¹,

Safavi²,

Karaky³

2011

JPR

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BackgroundKetamine, an N-methyl-D-aspartate receptor antagonist, can suppress hyperalgesia and allodynia. The purpose of the present study was to evaluate the clinical efficacy of preincisional intravenous or subcutaneous infiltration of ketamine for postoperative pain relief after appendectomy.MethodsNinety patients, aged 18–60 years, scheduled for appendectomy was enrolled in this study. Patients were divided into three groups of 30 each and received subcutaneous infiltration of ketamine 0.5 mg/kg (KS), intravenous ketamine 0.5 mg/kg (KI), or subcutaneous infiltration of normal saline 3 mL (C) before surgery. Visual analog scale (VAS) values and analgesic consumption were evaluated for 24 hours after surgery.ResultsVAS scores were significantly lower at the time of arrival in the recovery room, and at 10, 20, and 30 minutes thereafter in group KI and group KS compared with group C (P < 0.05). VAS scores were not significantly different between group KI and group KS at these intervals. Postoperative VAS scores were significantly lower at 6, 12, 18, and 24 hours in group KI compared with group C (P < 0.05). In group KS, the postoperative VAS score was significantly lower at 6 hours (P < 0.05). VAS scores were significantly lower at 12, 18, and 24 hours after surgery in group KI compared with group KS (P < 0.05).ConclusionA 0.5 mg/kg dose of ketamine given at approximately 15 minutes before surgery by the intravenous route provided analgesia for 24 hours after surgery in patients undergoing appendectomy.

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“…Artan dozlarda lidokain uygulamasının ağrıyı daha yüksek oranda azalttığına dair çalışmalar vardır (14) . Lidokaine fentanil (15) , remifentanil (16,17) , ketamin (18,19) , flurbiprofen (5) eklenmesinin de etkili olduğunu söyleyen yayınlar mevcuttur. Massad ve ark.…”

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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Prevention of pain with the injection of microemulsion propofol: a comparison of a combination of lidocaine and ketamine with lidocaine or ketamine alone

Cited by 19 publications

References 29 publications

Analgesic Effect of Low Dose Subcutaneous Ketamine Administration Before and After Cesarean Section

Analgesic Effect of Low Dose Subcutaneous Ketamine Administration Before and After Cesarean Section

Preincisional administration of intravenous or subcutaneous infiltration of low-dose ketamine suppresses postoperative pain after appendectomy

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

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