Effect of Intravenous Tramadol, Acetaminophen in Attenuating Pain on Propofol Injection: Comparison with Lignocaine: A Randomized, Double‑blind, Controlled Study

Authors

  •   Saurabh Biswal Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana
  •   Srilata Moningi Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana
  •   Gopinath Ramachandran Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana

Keywords:

Acetaminophen, lignocaine, pain, propofol, tramadol

Abstract

Objectives: Distress and pain due to propofol injection is a very common finding. The aim of our study was to assess the efficacy with lignocaine, tramadol, and acetaminophen pretreatment to alleviate the propofol pain. Materials and Methods: Ninety American Society of Anesthesiology (ASA) I and II adults, scheduled for various elective surgical procedures under general anesthesia, were included in the study. They were randomly divided into three groups with 30 patients in each group. Group A received pretreatment with intravenous (IV) lignocaine, group B received IV tramadol, and group C received IV acetaminophen. One‑fourth of the total calculated induction dose of propofol was administered over a period of 5 s. The patients were asked about the pain on injection. The intensity of pain was assessed using verbal rating score. A score of 0–3, which corresponded to no, mild, moderate, and severe pain was recorded. Categorical and continuous variables were compared between the groups using Chi‑square test and analysis of variance (ANOVA) test, respectively. Post hoc analysis was performed using Bonferroni test. Verbal rating scale (VRS), an ordered categorical variable, was compared between the groups using Wilcoxon signed‑rank test. A P value of tramadol = acetaminophen. Conclusion: Both tramadol and acetaminophen were clinically equivalent to lignocaine in their potency to decrease the incidence of propofol pain.

Downloads

Download data is not yet available.

Downloads

Published

2015-07-01

How to Cite

Biswal, S., Moningi, S., & Ramachandran, G. (2015). Effect of Intravenous Tramadol, Acetaminophen in Attenuating Pain on Propofol Injection: Comparison with Lignocaine: A Randomized, Double‑blind, Controlled Study. Karnataka Anaesthesia Journal, 1(3), 118–122. Retrieved from https://karnatakaanesthesiajournal.in/index.php/kaj/article/view/139393

Issue

Section

Original Articles

References

Jalota L, Kalira V, George E, Shi YY, Hornuss C, Radke O, et al. Prevention of pain on injection of propofol: Systematic review and meta‑analysis. BMJ 2011;342:d1110.

Picard P, Tramèr MR. Prevention of pain on injection with propofol: A quantitative systematic review. Anesth Analg 2000;90:963‑9.

Barker P, Langton JA, Murphy P, Rowbotham DJ. Effect of prior administration of cold saline on pain during propofol injection. A comparison with cold propofol and propofol with lignocaine. Anaesthesia 1991;46:1069‑70.

Fletcher GC, Gillespie JA, Davidson JA. The effect of temperature upon pain during injection of propofol. Anaesthesia 1996;51:498‑9.

Klement W, Arndt JO. Pain on injection of propofol: Effects of concentration and diluent. Br J Anaesth 1991;67:281‑4.

Drašković B, Knežević S, Radovanović D, Rakić G. Ondansetron, alfentanil and nitrous oxide in the prevention of pain on injection of propofol. Srp Arh Celok Lek 2013;141:61‑5.

Ahmed A, Sengupta S, Das T, Rudra A, Iqbal A. Pre‑treatment with intravenous granisetron to alleviate pain on propofol injection: A double‑blind, randomized, controlled trial. Indian J Anaesth 2012;56:135‑8.

Rasmussen KG, Ritter MJ. Anesthetic‑induced pain on injection in electroconvulsive therapy: Review of the literature and suggestions for prevention. J ECT 2014;30:203‑9.

Wang M, Wang Q, Yu YY, Wang WS. An effective dose of ketamine for eliminating pain during injection of propofol: A dose response study.Ann Fr Anesth Reanim 2013;32:e103‑6.

Zhang L, Zhu J, Xu L, Zhang X, Wang H, Luo Z, et al. Efficacy and safety of flurbiprofen axetil in the prevention of pain on propofol injection: A systematic review and meta‑analysis. Med Sci Monit 2014;20:995‑1002.

Rodrigues TA, Alexandrino RA, Kanczuk ME, Gozzani JL, Mathias LA. A comparative study of non‑lipid nanoemulsion of propofol with solutol and propofol emulsion with lecithin. Rev Bras Anestesiol 2012;62:325‑34.

Mallick A, Elliot SC, Krishnan K, Vucevic M. Lidocaine is more efficient than the choice of propofol formulations to reduce incidence of pain on induction. Eur J Anaesthesiol 2007;24:403‑7.

Hennies HH, Friderichs E, Wilsmann K, Floh e L. Effect of the opioid analgesic tramadol on inactivation of norepinephrine and serotonin.Biochem Pharmacol 1982;31:1654‑5.

Borazan H, Sahin O, Kececioglu A, Uluer MS, Et T, Otelcioglu S. Prevention of propofol injection pain in children: A comparison of pretreatment with tramadol and propofol‑lidocaine mixture. Int J Med Sci 2012;9:492‑7.

Memis D, Turan A, Karamanlioglu B, Kaya G, Pamukçu Z. The prevention of propofol injection pain by tramadol or ondansetron. Eur J Anaesthesiol 2002;19:47‑51.

Canbay O, Celebi N, Arun O, Karagöz AH, Saricaoğlu F, Ozgen S.Efficacy of intravenous acetaminophen and lidocaine on propofol injection pain. Br J Anaesth 2008;100:95‑8.

Borazan H, Erdem TB, Kececioglu M, Otelcioglu S. Prevention of pain on injection of propofol: A comparison of lidocaine with different doses of paracetamol. Eur J Anaesthesiol 2010;27:253‑7.

Lee YS, Kim H, Brahim JS, Rowan J, Lee G, Dionne RA. Acetaminophen selectively suppresses peripheral prostaglandin E2 release and increases COX‑2 gene expression in a clinical model of acute inflammation. Pain 2007;129:279‑86.

Wong WH, Cheong KF. Role of tramadol in reducing pain on propofol injection. Singapore Med J 2001;42:193‑5.

Kay B, Rolly G. I.C.I. 35868, a new intravenous induction agent. Acta Anaesthesiol Belg 1977;28:303‑16.

Thompson KA, Goodale DB. The recent development of propofol (DIPRIVAN). Intensive Care Med 2000;26(Suppl 4):S400‑4.

Angst MS, Mackey SC, Zupfer GH, Tataru CD, Brock‑Utne JG.Reduction of propofol injection pain with a double lumen i.v. set. J Clin Anesth 1997;9:462‑6.

Doenicke AW, Roizen MF, Rau J, O’Connor M, Kugler J, Klotz U, et al. Pharmacokinetics and pharmacodynamics of propofol in a new solvent. Anesth Analg 1997;85:1399‑403.

Klement W, Arndt JO. Pain on i.v. injection of some anaesthetic agents is evoked by the unphysiological osmolality or pH of their formulations. Br J Anaesth 1991;66:189‑95.

Nakane M, Iwama H. A potential mechanism of propofol‑induced pain on injection based on studies using nafamostat mesilate. Br J Anaesth 1999;83:397‑404.

Lomax D. Propofol injection pain. Anaesth Intensive Care 1994;22:500‑1.

Johnson RA, Harper NJ, Chadwick S, Vohra A. Pain on injection of propofol. Methods of alleviation. Anaesthesia 1990;45:439‑42.

Scott RP, Saunders DA, Norman J. Propofol: Clinical strategies for preventing the pain of injection. Anaesthesia 1988;43:492‑4.

King SY, Davis FM, Wells JE, Murchison DJ, Pryor PJ. Lidocaine for the prevention of pain due to injection of propofol. Anesth Analg 1992;74:246‑9.

Levant A, Levy E, Argaman M, Fleisher‑Berkovich S. Kinins and neuroinflammation: Dual effect on prostaglandin synthesis. Eur J Pharmacol 2006;546:197‑200.

Ando R, Watanabe C. Characteristics of propofol‑evoked vascular pain in anaesthetized rats. Br J Anaesth 2005;95:384‑92.

Stein C. The control of pain in peripheral tissue by opioids. N Engl J Med 1995;332:1685‑90.