Comparative Study of Lidocaine and Palonosetron Pretreatment in Reduction of Propofol Induced Injection Pain UC13-UC16
Dr. Suruchi Ambasta,
502, Faculty Apartment, Dr Ram Manohar Lohia, Institute of Medical Sciences, Vibhuti Khand, Gomti Nagar,
Lucknow-226010, Uttar Pradesh, India.
Introduction: Propofol is very popular as an induction agent in modern day anaesthesia because of its favourable pharmacodynamics and fewer side effects. Any pain pre or post-anaesthesia leads to patient dissatisfaction. The incidence of pain during propofol induction is almost 70%.
Aim: To compare palanosetron and lidocaine to each other as well as with the control group receiving normal saline as placebo in decreasing propofol induced injection pain and to compare patient satisfaction in both the test groups.
Materials and Methods: A total of 150 patients were randomised to constitute three groups. Group L who received 0.5 mg/kg of 2% lidocaine, Group P received palonosetron 0.075 mg, and Group N who received normal saline 0.9% constituted the control group. Patients were given a 5 mL pretreatment solution, containing either lignocaine 0.5 mg/kg, palonosetron 0.075 mg or 0.9% normal saline intravenously. Following pretreatment, venous drainage was occluded at midarm level with a tourniquet. Tourniquet was released after one minute. Propofol injection was given over five seconds at 25% of the total calculated induction dose. Patients were then interviewed about the magnitude of pain and rated as per a pain scale. Descriptive statistics such as range, mean, Standard Deviation (SD) were used to summarise the baseline clinical and demographic profile of the patients. Chi-square test was performed for comparison of categorical data.
Results: Both the study drugs i.e., lidocaine and palonosetron caused significant reduction in pain as compared to the placebo (normal saline) group. Only 20% of patients had pain free induction (at five seconds) in saline group as compared to 64% and 70% in Groups P and L respectively. Comparison among three groups was highly significant with p<0.001.
Conclusion: Palonosetron was almost as effective as lidocaine in reducing propofol induced injection pain. Palonosetron has an added advantage because of its antiemetic property so can be chosen as an alternative to lidocaine.