This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (21) Citing Articles via Google Scholar Google Scholar Articles by Agarwal, A. Articles by Singh, U. Search for Related Content PubMed PubMed Citation Articles by Agarwal, A. Articles by Singh, U. Related Collections Complications Pain Pharmacology

---

ANESTHETIC PHARMACOLOGY

Pretreatment with Thiopental for Prevention of Pain Associated with Propofol Injection

Departments of Anesthesia and *Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

Address correspondence and reprint requests to Dr. Anil Agarwal, Type IV/48, SGPGIMS, Lucknow 226 014, India. Address email to aagarwal{at}sgpgi.ac.in

Propofol causes pain on IV injection in 28%–90% of patients. A number of techniques have been tried to minimize propofol-induced pain, with variable results. We compared the efficacy of pretreatment with thiopental 0.25 mg/kg and 0.5 mg/kg and lidocaine 40 mg after venous occlusion for prevention of propofol-induced pain. One-hundred-twenty-four adult patients, ASA physical status I–II, undergoing elective surgery were randomly assigned into 4 groups of 31 each. Group I received normal saline, group II received lidocaine 2% (40 mg), and groups III and IV received thiopental 0.25 mg/kg and 0.5 mg/kg, respectively. All pretreatment drugs were made in 2 mL and were accompanied by manual venous occlusion for 1 min. Propofol was administered after release of venous occlusion. Pain was assessed with a four-point scale: 0 = no pain, 1 = mild pain, 2 = moderate pain, and 3 = severe pain at the time of propofol injection. Twenty-four patients (77%) complained of pain in the group pretreated with normal saline as compared with 12 (39%), 10 (32%), and 1 (3%) in the groups pretreated with lidocaine 40 mg, thiopental 0.25 mg/kg, and thiopental 0.5 mg/kg, respectively (P < 0.05). Thiopental 0.5 mg/kg was the most effective treatment. We therefore suggest routine pretreatment with thiopental 0.5 mg/kg along with venous occlusion for 1 min for prevention of pain associated with propofol injection.

IMPLICATIONS: Pain associated with IV injection of propofol is seen in 28%–90% patients. Pretreatment with thiopental 0.25 mg/kg and 0.5 mg/kg after manual venous occlusion for 1 min effectively attenuated pain associated with propofol injection. Thiopental 0.5 mg/kg was the most effective in prevention of propofol pain and can be used routinely.

This article has been cited by other articles:

				O. Canbay, N. Celebi, O. Arun, A. H. Karagoz, F. Saricaoglu, and S. Ozgen Efficacy of intravenous acetaminophen and lidocaine on propofol injection pain Br. J. Anaesth., January 1, 2008; 100(1): 95 - 98. [Abstract] [Full Text] [PDF]

				N. C. H. Sun, A. Y. C. Wong, and M. G. Irwin A Comparison of Pain on Intravenous Injection Between Two Preparations of Propofol Anesth. Analg., September 1, 2005; 101(3): 675 - 678. [Abstract] [Full Text] [PDF]

				T. Lacy, N. Roy Connelly, K. Freeman, A. Agarwal, M. F. Ansari, S. Dhiraaj, and M. Raza Don't Use Thiopental to Decrease Propofol Injection Pain * Response Anesth. Analg., September 1, 2004; 99(3): 953 - 954. [Full Text] [PDF]