Abstract
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. Ninety ASA I/II patients aged 20-60years were randomly assigned to three groups to receive lidocaine 20mg (group L), lidocaine 20mg + metoclopramide 10mg (group LM), or lidocaine 20mg + ketamine 5mg (group LK), respectively, with venous occlusion for 1min using a forearm tourniquet. Propofol 0.5mg/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. 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). The lidocaine-ketamine combination is most effective for decreasing the pain on propofol injection.
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