• Leyla Iyilikci, Bahar Kuvaki Balkan, Erol Gökel, Ali Günerli, and Hülya Ellidokuz.
• Department of Anesthesiology, Dokuz Eylul University, School of Medicine, Izmir-Turkey, Turkey. leyla.iyilikci@deu.edu.tr
• J Clin Anesth. 2004 Nov 1;16(7):499-502.

Study ObjectiveTo compare the efficacy of alfentanil, remifentanil, and saline in minimizing the propofol injection pain.DesignRandomized, double-blind study.SettingUniversity hospital.Patients175 ASA physical status I and II, adult female patients undergoing minor gynecological procedures with general anesthesia.InterventionsUnpremedicated patients were randomly allocated to one of four groups. Patients received 2 mL (1 mg) of alfentanil (n=43), 2 mL of remifentanil 0.01 mg (n = 43), 2 mL of remifentanil 0.02 mg (n=45), or 2 mL of saline (n=44) 30 seconds prior to administration 5 mL of propofol 1%.MeasurementsPatients were asked whether they had pain due to propofol injection. Their pain scores were evaluated with a Visual Analogue Scale. In the Postanesthesia Care Unit, frequency of postoperative nausea, vomiting, hypotension, and flushing were all determined.Main ResultThe remifentanil and alfentanil groups showed significantly less frequency and severity of pain than the saline group (p <0.05). When the alfentanil group was compared with the remifentanil groups, significant differences in pain relief associated with injection of propofol (p <0.001) were noted. Remifentanil 0.02 mg relieved pain associated with injection of propofol more effectively than remifentanil 0.01 mg (p <0.001).ConclusionsThe remifentanil and alfentanil groups showed significantly less frequency and severity of pain than did the saline group. Remifentanil was effective in preventing propofol injection pain, and should be used at a dose of at least 0.02 mg for this purpose. Remifentanil may be an alternative drug for prevention of propofol injection pain.

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