Comparison of Effects of Ketamine, Esmolol and Lidocaine on Propofol Injection Pain

Abstract

Objective: Propofol is the most frequently used agent for intravenous anesthesia administration. However, during propofol injection, pain may develop in the hand and forearm region and cause unwanted situations. Different applications have been used to prevent propofol injection pain. Although lidocaine is often used for proprofol injection pain, anesthetic agent ketamine, which has an analgesic feature, is also preferred. In recent years, the analgesic feature of esmolol, a short-acting beta blocker, has been emphasized. Our aim was to evaluate the effects of three different agents, ketamine, esmolol or lidocaine, on the severity of pain developing by propofol injection. Also, hemodynamic effects were investigated. Methods: Sixty cases in ASA groups I and II, aged from 18 to 80 years old undergoing elective operations included in the study. To reduce the pain due to propofol injection, patients were given either 0.5 mg/kg ketamine, 0.5 mg/kg esmolol HCl or 0.5 mg/kg lidocaine. For induction 1% propofol injection was administered, presence and severity of pain in the arm was questioned and recorded. To evaluate the severity of pain developing due to propofol injection, a 4-point numerical scale was used (no pain: 1, mild pain: 2, moderate pain: 3 and severe pain: 4). Arm pull motion was also recorded. Results: There were no significant differences between the groups according to the severity of pain and pulling arm rates. There was no significant difference between hemodynamic parameters in the groups preoperatively, first, 5th, 10th, 15th, 20th and 30th minute. Conclusion: Ketamine, esmolol, and lidocaine can safely control the severity of pain developing by propofol injection. Esmolol, ketamine and lidocaine provided effective analgesia at the doses used in our study without affecting the hemodynamic findings of the patients.