Comparison among the effect of ondansetron, lidocaine and combination of ondansetron and lidocaine on microemulsion propofol injection pain

Park, Jung Sun; Lim, Yun Hee; Lee, Sang Seock; Yoo, Byung Hoon; Yon, Jun Heum

Abstract

BACKGROUND
The pain caused by injection of propofol is known to be related to the concentration of aqueous free propofol. Microemulsion propofol can cause a serious pain because it has 7 times higher concentration of aqueous free propofol. We used ondansetron, lidocaine, ondansetron lidocaine as pretreatment to compare the effect for injection pain of microemulsion propofol.
METHODS
75 patients, ASA physical status I or II were enrolled. We randomly allocated into Group L (n = 25) received 2% lidocaine 40 mg, group O (n = 25) received ondansetron 4 mg and group M (n = 25) received ondansetron 4 mg plus 2% lidocaine 40 mg as pretreatment. After instituting standard monitoring, the venous drainage was occluded using a pneumatic tourniquet at 25 cm proximal to venous line. The patients were pretreated over a period of 15 seconds with one of the pretreatment drug. After releasing the tourniquet, microemulsion propofol was injected. We asked the patient about degree of injection pain until loss of consciousness, by using 0-100 point pain intensity numerical rating scale (PI-NRS). In the recovery room, we asked the patient whether they recall injection pain.
RESULTS
There were significant differences in the group L and the group M compared with group O on PI-NRS (P < 0.05). The incidence of injection pain was significantly lower in group L and group M than group O.
CONCLUSIONS
Pretreatment of lidocaine and lidocaine + ondansetron is more effective than ondansetron alone for reducing pain on injection of microemulsion propofol.