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

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Abstract

Purpose

Propofol 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.

Methods

Ninety 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.

Results

The 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).

Conclusion

The lidocaine–ketamine combination is most effective for decreasing the pain on propofol injection.

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Acknowledgments

The work was carried out at the Department of Anesthesiology and Intensive Care, Vardhaman Mahavir Medical College & Associated Safdarjung Hospital, New Delhi, India. We thank Dr. M Kalaivani, Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, for the statistical analysis.

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Author notes

  1. Kapil Chaudhary

    Present address: Department of Anesthesiology and Intensive Care, G B Pant Hospital & Associated Maulana Azad Medical College, New Delhi, India

Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, Vardhaman Mahavir Medical College & Associated Safdarjung Hospital, New Delhi, India

    Kapil Chaudhary, Pramod Gupta & Anoop Raj Gogia

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  1. Kapil Chaudhary
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  2. Pramod Gupta
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Correspondence to Kapil Chaudhary.

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Chaudhary, K., Gupta, P. & Gogia, A.R. A prospective, randomized, double-blind study to compare the efficacy of lidocaine + metoclopramide and lidocaine + ketamine combinations in preventing pain on propofol injection. J Anesth 27, 402–406 (2013). https://doi.org/10.1007/s00540-012-1533-0

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  • DOI: https://doi.org/10.1007/s00540-012-1533-0

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