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Anesth Analg 2004;99:117-119
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000117002.03919.49

ANESTHETIC PHARMACOLOGY

Pain During Injection of Propofol: The Effect of Prior Administration of Butorphanol

Anil Agarwal, MD, Mehdi Raza, MD, Sanjay Dhiraaj, MD, Ravinder Pandey, MD, Devendra Gupta, MD, Chandra Kant Pandey, MD, Prabhat K Singh, MD, and Uttam Singh, PhD

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

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

Propofol causes pain or discomfort on injection in 28%–90% of patients. A number of techniques have been tried for minimizing propofol-induced pain with variable results. We compared the efficacy of butorphanol and lidocaine for prevention of propofol-induced pain. One-hundred-fifty ASA I–II adults, undergoing elective surgery were randomly assigned into 3 groups of 50 each. Group I (NS) received normal saline, Group II (L) received lidocaine 2% (40 mg), and Group III (B) received butorphanol 2 mg. All patients received pretreatment solutions made in 2 mL with normal saline administered over 5 s. One min after pretreatment patients received one-fourth of the total calculated dose of propofol (2.5 mg/kg) over 5 s. Assessment of pain with IV propofol was done by using a four-point scale: 0 = no pain, 1 = mild pain, 2 = moderate pain and 3 = severe pain at the time of propofol injection. In the control Group 39 (78%) patients had pain during propofol injection as compared to 21 (42%) and 10 (20%) in the lidocaine and butorphanol groups, respectively (P < 0.05). Butorphanol was the most effective. We therefore suggest the IV pretreatment with butorphanol 2 mg for attenuation of pain associated with propofol injection.

IMPLICATIONS: Pain associated with IV injection of propofol is seen in 28%–90% patients. Pretreatment with butorphanol 2 mg and lidocaine 40 mg attenuated the incidence and severity of pain associated with propofol injection. Butorphanol was the most effective and can be used routinely to prevent propofol pain.




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M. Lippmann and C. Z. Kakazu
Pain Reduction by IV Butorphanol Prior to Propofol
Anesth. Analg., March 1, 2005; 100(3): 903 - 903.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.