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Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain

Year 2021, Volume: 48 Issue: 4, 669 - 677, 01.12.2021
https://doi.org/10.5798/dicletip.1001895

Abstract

Objective: Propofol is the most frequently used agent for intravenous anesthesia administration. However, during propofol injection, pain may develop in the hand and forearm region and cause unwanted situations. Different applications have been used to prevent propofol injection pain. Although lidocaine is often used for proprofol injection pain, anesthetic agent ketamine, which has an analgesic feature, is also preferred. In recent years, the analgesic feature of esmolol, a short-acting beta blocker, has been emphasized.
Our aim was to evaluate the effects of three different agents, ketamine, esmolol or lidocaine, on the severity of pain developing by propofol injection. Also, hemodynamic effects were investigated.
Methods: Sixty cases in ASA groups I and II, aged from 18 to 80 years old undergoing elective operations included in the study. To reduce the pain due to propofol injection, patients were given either 0.5 mg/kg ketamine, 0.5 mg/kg esmolol HCl or 0.5 mg/kg lidocaine.
For induction 1% propofol injection was administered, presence and severity of pain in the arm was questioned and recorded. To evaluate the severity of pain developing due to propofol injection, a 4-point numerical scale was used (no pain: 1, mild pain: 2, moderate pain: 3 and severe pain: 4). Arm pull motion was also recorded.
Results: There were no significant differences between the groups according to the severity of pain and pulling arm rates. There was no significant difference between hemodynamic parameters in the groups preoperatively, first, 5th, 10th, 15th, 20th and 30th minute.
Conclusion: Ketamine, esmolol, and lidocaine can safely control the severity of pain developing by propofol injection. Esmolol, ketamine and lidocaine provided effective analgesia at the doses used in our study without affecting the hemodynamic findings of the patients.

References

  • 1.Stark R, Binks S, Dutka V, et al. A review ofthesafetyandtoler¬ance of propofol (Diprivan)PostgradMed J 1984; 61: 152-6.
  • 2.Lui JT, Huang SJ, Yang CY, et al. Rocuronium-induced generalized spontaneous movements causepulmonary aspiration. Chang Gung Med J 2002; 25:617-20.
  • 3. Jalota L, Kalira V, George E, et al. Prevention of painon injection of propofol: systematic review andmeta-analysis. BMJ 2011; 15:342.
  • 4.Picard P andTramer MR. Prevention of pain oninjection with propofol: a quantitative system¬aticreview. Anesth Analg 2000; 90: 963-9.
  • 5.Demir A, Aydınlı B, Tezcan, et al. Influence ofTemperature and pH Changes on Propofol InjectionPain. Turk J Anaesth Reanim 2013; 41: 34-7.
  • 6.Sun J, Zhou R, Lin W, et al. Magnesium sulfate pluslidocaine reduces propofol injection pain: a double-blind, randomized study. Clin Ther 2016; 38: 31-8.
  • 7.Sapate M, Andurkar U, Markandeya M, et al. Tostudy the effect of injection dexmedetomidine forprevention of pain dueto propofol injection and tocompare it with injection lignocaine. Braz JAnesthesiol 2015; 65: 466-9.

Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain

Year 2021, Volume: 48 Issue: 4, 669 - 677, 01.12.2021
https://doi.org/10.5798/dicletip.1001895

Abstract

Objective: Propofol is the most frequently used agent for intravenous anesthesia administration. However, during propofol injection, pain may develop in the hand and forearm region and cause unwanted situations. Different applications have been used to prevent propofol injection pain. Although lidocaine is often used for proprofol injection pain, anesthetic agent ketamine, which has an analgesic feature, is also preferred. In recent years, the analgesic feature of esmolol, a short-acting beta blocker, has been emphasized.
Our aim was to evaluate the effects of three different agents, ketamine, esmolol or lidocaine, on the severity of pain developing by propofol injection. Also, hemodynamic effects were investigated.
Methods: Sixty cases in ASA groups I and II, aged from 18 to 80 years old undergoing elective operations included in the study. To reduce the pain due to propofol injection, patients were given either 0.5 mg/kg ketamine, 0.5 mg/kg esmolol HCl or 0.5 mg/kg lidocaine.
For induction 1% propofol injection was administered, presence and severity of pain in the arm was questioned and recorded. To evaluate the severity of pain developing due to propofol injection, a 4-point numerical scale was used (no pain: 1, mild pain: 2, moderate pain: 3 and severe pain: 4). Arm pull motion was also recorded.
Results: There were no significant differences between the groups according to the severity of pain and pulling arm rates. There was no significant difference between hemodynamic parameters in the groups preoperatively, first, 5th, 10th, 15th, 20th and 30th minute.
Conclusion: Ketamine, esmolol, and lidocaine can safely control the severity of pain developing by propofol injection. Esmolol, ketamine and lidocaine provided effective analgesia at the doses used in our study without affecting the hemodynamic findings of the patients.
Keywords: Propofol injection pain, analgesic effect, esmolol, ketamine, lidocaine

References

  • 1.Stark R, Binks S, Dutka V, et al. A review ofthesafetyandtoler¬ance of propofol (Diprivan)PostgradMed J 1984; 61: 152-6.
  • 2.Lui JT, Huang SJ, Yang CY, et al. Rocuronium-induced generalized spontaneous movements causepulmonary aspiration. Chang Gung Med J 2002; 25:617-20.
  • 3. Jalota L, Kalira V, George E, et al. Prevention of painon injection of propofol: systematic review andmeta-analysis. BMJ 2011; 15:342.
  • 4.Picard P andTramer MR. Prevention of pain oninjection with propofol: a quantitative system¬aticreview. Anesth Analg 2000; 90: 963-9.
  • 5.Demir A, Aydınlı B, Tezcan, et al. Influence ofTemperature and pH Changes on Propofol InjectionPain. Turk J Anaesth Reanim 2013; 41: 34-7.
  • 6.Sun J, Zhou R, Lin W, et al. Magnesium sulfate pluslidocaine reduces propofol injection pain: a double-blind, randomized study. Clin Ther 2016; 38: 31-8.
  • 7.Sapate M, Andurkar U, Markandeya M, et al. Tostudy the effect of injection dexmedetomidine forprevention of pain dueto propofol injection and tocompare it with injection lignocaine. Braz JAnesthesiol 2015; 65: 466-9.
There are 7 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Döndü Genç Moralar This is me

Aygen Ülkü Türkmen This is me

Aysel Hatice Altan This is me

Publication Date December 1, 2021
Submission Date August 21, 2021
Published in Issue Year 2021 Volume: 48 Issue: 4

Cite

APA Moralar, D. G., Türkmen, A. Ü., & Altan, A. H. (2021). Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain. Dicle Tıp Dergisi, 48(4), 669-677. https://doi.org/10.5798/dicletip.1001895
AMA Moralar DG, Türkmen AÜ, Altan AH. Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain. diclemedj. December 2021;48(4):669-677. doi:10.5798/dicletip.1001895
Chicago Moralar, Döndü Genç, Aygen Ülkü Türkmen, and Aysel Hatice Altan. “Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain”. Dicle Tıp Dergisi 48, no. 4 (December 2021): 669-77. https://doi.org/10.5798/dicletip.1001895.
EndNote Moralar DG, Türkmen AÜ, Altan AH (December 1, 2021) Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain. Dicle Tıp Dergisi 48 4 669–677.
IEEE D. G. Moralar, A. Ü. Türkmen, and A. H. Altan, “Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain”, diclemedj, vol. 48, no. 4, pp. 669–677, 2021, doi: 10.5798/dicletip.1001895.
ISNAD Moralar, Döndü Genç et al. “Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain”. Dicle Tıp Dergisi 48/4 (December 2021), 669-677. https://doi.org/10.5798/dicletip.1001895.
JAMA Moralar DG, Türkmen AÜ, Altan AH. Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain. diclemedj. 2021;48:669–677.
MLA Moralar, Döndü Genç et al. “Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain”. Dicle Tıp Dergisi, vol. 48, no. 4, 2021, pp. 669-77, doi:10.5798/dicletip.1001895.
Vancouver Moralar DG, Türkmen AÜ, Altan AH. Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain. diclemedj. 2021;48(4):669-77.