Comparison of Pre-Treatment with OndansetronVersus Tramadol For Reduction of Pain on Injection of Propofol-A Prospective, Randomised Study

Abstract

Background and aims:Propofol is a commonly used intravenous induction agent. But a significant side effect of propofol is pain on injection. In this study our aim was to compare the effectiveness of ondansetron pretreatment versus tramadol pre-treatment in alleviating propofol injection pain. Method: 300 patients were randomly assigned to one of the following three groups. Group I received 2 ml pre-treatment with 4 mg ondansetronin normalsaline, group II received 2 ml pre-treatment with 50 mg tramadol in normal saline, and group III received pre-treatment with 2 ml normal saline. A 20 gauge cannula was placed into the largest vein on the dorsum of the hand. Venous drainage was occluded by holding proximally by hand, and then the drug was injected. After 60 seconds, the occlusion was released and propofol 2ml was injected intravenously over 5 seconds and pain assessment was made. Results: Ondansetron and tramadolsignificantly reduced the incidence and severity of propofol injection pain more than placebo (P=0.001). The efficacy of ondansetron in alleviating the pain on injection of propofol was no different from tramadol (P=0.330). Ondansetron pre-treatment may be used to reduce the incidence of pain on injection of propofol, an advantage added to its action of prevention of postoperative nausea and vomiting.