Anesth Analg 2002;94:1040-1041
© 2002 International Anesthesia Research Society
LETTERS TO THE EDITOR
Reduction of Pain on Injection of Propofol: A Comparison of Fentanyl with Remifentanil
Gökcen Basaranoglu, MD,
Veysel Erden, MD, and
Hamdi Delatioglu, MD
Department of Anesthesiology, Vakif Gureba Hospital, Istanbul, Turkey
To the Editor:
We read with interest the article by Picard and Tramér (1). We agree that, as mentioned in the article, a disadvantage of propofol is pain on injection. Thus, we compared the effect of fentanyl and remifentanil on pain during injection of propofol.
In this trial, the study was approved by the local Medical Ethics Committee, and informed consent was obtained from the patients scheduled for surgery. Seventy-five unpremedicated patients were randomly allocated to one of three groups (n = 25 respectively). There were no intergroup differences in age, weight, or gender. Group P, normal saline before propofol 2 mg/kg, group F, fentanyl 1 µg/kg before propofol, group R, remifentanil 1 µg/kg before propofol. A 20-gauge IV cannula was inserted on the dorsum of the hand. Propofol 10 mL (100 mg) was injected over 30 s. Expression of pain by strong vocal response on response accompanied by facial grimacing or withdrawal of arm was scored as severe pain. Verbal expression of pain without grimacing or withdrawal of arm was scored as moderate pain. If severe or moderate pain was not observed within 30 s, the patients were asked whether they had any discomfort in the arms; if they answered "yes," this was scored as mild pain; if they answered "no," this was scored as no pain (2). The assessments of pain on injection of propofol were performed by a blinded observer. Kruskal-Wallis nonparametric analysis of variance test was used.
Incidence of pain scores in each group is shown Table 1. There were no significant differences among three groups in pain score (Kruskal-Wallis = 5.37 and P > 0.05).
In conclusion, our observations suggest that neither fentanyl (1 µg/kg) nor remifentanil (1 µg/kg) pretreatment reduces the pain on injection of propofol.
References
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Picard P, Tramér MR. Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg 2000; 90: 963–9.[Abstract/Free Full Text]
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Ozturk E, Izdes S, Babacan A, Kaya K. Temperature of propofol does not reduce the incidence of injection pain. Anesthesiology 1998; 89: 1041.[ISI][Medline]
