Small-dose Ketamine Comparison with Lidocaine in The Prevention of Propofol-Induced Pain
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Abstract
Background: Propofol is a widely used anesthetic agent. Pain at injection site is a common problem. Ketamine has been reported to be effective in reducing propofol- induced pain.
Objective: To compare the efficacy of intravenous preemptive with ketamine 10 mg and lidocaine 40 mg in reducing the frequency and severity of pain due to propofol injection.
Methods: In this prospective, randomized, placebo-controlled, double-blinded study, 210 patients with ASA physical status l-ll undergoing elective surgery under general anesthesia were randomly allocated into 3 groups. Group S received normal saline; group L received 40 mg of lidocaine and group K received 10 mg of ketamine. Forty-fire seconds after the preemptive bolus, patients were injected with 2 mg/kg of propofol into the dorsal hand vein. Pain assessment was made 15 seconds after injection of propofol using 4- point verbal rating scale (0 = none, 1 = mild, 2 = moderate, 3 = severe)
Statistical analysis: Analysis of variance (ANOVA), chi - square or Kruskal-Wallis test were used where appropriate for comparing data among the three groups. If ANOVA identified significant differences, LSD test was used for post hoc analysis, p value < 0.05 considered statistically significant.
Results: The overall incidence of propofol injection pain was 77.1% of patients in the control group as compared to 25.7% with ketamine 10 mg and 42.9% with lidocaine 40 mg (p < 0.001). However, there were no significant differences between ketamine and lidocaine groups (p = 0.08). The incidence of moderate to severe pain was lower in ketamine and lidocaine groups compared with the control group (14.3%, 18.6% and 51.4% respectively).
Conclusion: Pretreatment with ketamine 10 mg and lidocaine 40 mg were equally effective reducing pain during propofol injection.
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References
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