Prevention of immediate and delayed pain on propofol injection: A comparative study of pretreatment with lignocaine and ondansetrone, India

Introduction: Pain on propofol injection (POPI) is a common problem and can be very distressing to the patient. POPI could be immediate as well as delayed after 10–20s. Many studies have shown the efficacy of Lignocaine in reducing this pain. Ondansetrone is found to have 15 times more potent local anesthetic property compared to Lignocaine. In this study we have compared the efficacy of Ondansetrone and Lignocaine pretreatment in reducing pain on propofol injection. during induction of anaesthesia. Aims: To compare the efficacy of the pretreatment with Ondansetrone with that of Lignocaine in reducing the pain injection of propofol during induction of anaesthesia. Materials and methods: A randomized control study was conducted on ninety adult patients aged between 20-60 yrs belonging ASA 1 and ASA 2 grade scheduled for various elective surgeries. Patients were assigned to one of the three groups: Group 1 to receive 5ml of 0.9% saline, Group 2 to receive 50 mgs of Lignocaine diluted in 5 ml, Group 3 to receive 4 mgs of Ondensetrone diluted in 5ml. The injections were given on the dorsum of the hand using 20G cannula. Tourniquet applied above the level cannula was released after one minute and then calculated dose of propofol was injected at a rate of two ml every five seconds. During injections patients were asked about the pain or discomfort at the site of injection and their behavioural signs were assessed using Mc Cririck and Hunter scale. Results: Lignocaine and Ondansetrone significantly reduced the incidence and severity of pain on propofol injection more than placebo (p <0.01-S). The efficacy of Ondensetrone in alleviating the pain on injection of Propofol was statistically comparable to that of Lignocaine. Conclusion: Intravenous Ondansetrone pretreatment may be used to reduce the incidence of immediate and delayed pain on injection of propofol