• Kalindi DeSousa and Mohamed Shaaban Ali.
• Department of Anaesthesia and ICU, Al Salam International Hospital, 35151, Kuwait, Kuwait. kalindidesousa@gmail.com
• J Anesth. 2011 Dec 1;25(6):879-83.

PurposeSince the introduction of propofol, several drugs and methods have been used to alleviate the pain on its injection. This study was designed to evaluate the effect of adding sevoflurane 3% during preoxygenation in alleviation of pain on propofol injection.MethodsIn this randomized single-blinded study, 100 patients were randomly allocated equally into five groups: sevoflurane-lidocaine-tourniquet (SLT), sevoflurane-lidocaine (SL), lidocaine-tourniquet (LT), lidocaine (L), and sevoflurane (S). Approximately 10 min before the induction of anesthesia, midazolam 1-2 mg was administered intravenously to all patients. All patients received fentanyl 1 µg/kg as pretreatment and a full induction dose of propofol. A blinded anesthesia nurse assessed pain and hand movements throughout the injection of propofol.ResultsIn the SLT group, all patients (100%) were pain free and had no hand movements. There was no significant difference in pain grade or in hand movements between the L and the S groups, or between the SLT and the SL groups. However, significant differences were observed in pain grade between the SLT and the L groups as well as between the SLT and the S groups. In addition, a significant difference in hand movement was observed only between the SLT and the S groups.ConclusionThe addition of 3% sevoflurane at the time of preoxygenation for 1 min along with routine use of lidocaine-tourniquet completely prevented pain upon propofol injection, whereas sevoflurane by itself provided similar analgesia to premixed lidocaine with propofol.

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