Gut Liver.  2021 Jul;15(4):562-568. 10.5009/gnl20243.

Pain Intensity at Injection Site during Esophagogastroduodenoscopy Using Long- and MediumChain versus Long-Chain Triglyceride Propofol: A Randomized Controlled Double-Blind Study

Affiliations
  • 1Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
  • 2Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea

Abstract

Background/Aims
The intensities of injection pain resulting from the use of long- and mediumchain triglyceride (LCT/MCT) propofol and conventional LCT propofol during esophagogastroduodenoscopy (EGD) have yet to be compared. We aimed to determine the pain intensity caused by different formulations of propofol and to evaluate the formulation that would be preferred by patients as a sedative agent during their next procedure.
Methods
This study was a single-center, randomized, controlled, and double-blind trial. Pain intensity was estimated 30 seconds after propofol injection by an examiner who was blinded to the group assignment using a numeric (0–10) pain rating scale (NPRS). After 1 week, the patients were asked whether they could recall the pain and were willing to receive the same agent for their next EGD.
Results
One hundred twenty-nine patients were randomly assigned to LCT/MCT or LCT group. Although there was no significant difference in pain incidence between the LCT/MCT and LCT groups (52.9% vs 65.6%, p=0.156), the pain intensity was significantly lower in the LCT/MCT group (NPRS median [interquartile range]; 1 (0–2) vs 2 (0–5), p=0.005). After 1 week, fewer patients in the LCT/MCT group recalled the pain (19.1% vs 63.9%, p<0.001) and more patients in the LCT/MCT group were more willing to use the same agent for their next procedure (86.8% vs 72.1%, p=0.048) than in the LCT group.
Conclusions
LCT/MCT propofol significantly reduced injection pain intensity compared to LCT propofol during EGD and preferred by patients as a sedative agent during their next EGD.

Keyword

Endoscopy; Medium chain triglyceride; Propofol; Pain
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