• Journal of anesthesia · Jun 2013

    Randomized Controlled Trial

    A prospective, randomized, double-blind study to compare the efficacy of lidocaine + metoclopramide and lidocaine + ketamine combinations in preventing pain on propofol injection.

    • Kapil Chaudhary, Pramod Gupta, and Anoop Raj Gogia.
    • Department of Anesthesiology and Intensive Care, G B Pant Hospital & Associated Maulana Azad Medical College, New Delhi, India. kapsdr@yahoo.com
    • J Anesth. 2013 Jun 1; 27 (3): 402-6.

    PurposePropofol injection is known to cause distressing pain, and various methods have been used to decrease this pain. We investigated the efficacy of the lidocaine + metoclopramide and lidocaine + ketamine combinations on modulating propofol injection pain.MethodsNinety ASA I/II patients aged 20-60 years were randomly assigned to three groups to receive lidocaine 20 mg (group L), lidocaine 20 mg + metoclopramide 10 mg (group LM), or lidocaine 20 mg + ketamine 5 mg (group LK), respectively, with venous occlusion for 1 min using a forearm tourniquet. Propofol 0.5 mg/kg was subsequently administered into a dorsal hand vein, and pain was assessed during its injection using a verbal rating score. The results were analyzed statistically with analysis of variance, the chi-square test, and the Wilcoxon rank sum test, where appropriate. The significance level was set at p < 0.05.ResultsThe incidence of pain was rated to be significantly less in patients in groups LM (40 %) and LK (6.7 %) than in those in group L (83.3 %) (p = 0.001 and p < 0.001, respectively). The pain score [median (range)] was also significantly less in patients in groups LM [0 (0-3)] and LK [0 (0-2)] than in those in group L [2 (0-3)] (p = 0.001 for both groups).ConclusionThe lidocaine-ketamine combination is most effective for decreasing the pain on propofol injection.

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