Effect of parecoxib pretreatment and venous occlusion on propofol injection pain: a prospective, randomized, double-blinded, placebo-controlled study

Abstract

Study Objective To investigate the effect of parecoxib pretreatment with venous occlusion on propofol injection pain. Design Prospective, randomized, double-blinded, placebo-controlled study. Setting Operating room of a tertiary-care medical center. Patients 150 ASA physical status I patients scheduled for elective surgery. Interventions Patients were randomized to three groups of 50 patients each to receive pretreatment with normal saline (Group NS), parecoxib 20 mg (Group P20), or parecoxib 40 mg (Group P40). All groups underwent venous occlusion for two minutes before propofol was injected. All pretreatment drugs were prepared in 5 mL doses. Measurements Pain scores were obtained by a study-blinded observer during propofol injection following the different pretreatment solutions. Main Results Pain scores among the three groups were significantly different ( P ≤ 0.001). In Group NS, 29 (58%) patients had pain during propofol injection compared with 22 (40%) Group P20 and 13 (26%) Group P40 patients ( P ≤ 0.005). Pain was significantly reduced in Group P40 ( P ≤ 0.001) compared with the control group. Moderate to severe pain was experienced by 18 (36%) Group NS and 4 (8%) Group P20 patients, whereas no Group P40 patient experienced moderate or severe pain ( P < 0.001). Reduction in pain severity was statistically significant after pretreatment with either parecoxib 20 mg ( P = 0.002) or parecoxib 40 mg ( P < 0.001). Conclusion Parecoxib 40 mg with venous occlusion is effective in reducing the frequency and severity of pain with propofol injection. Pretreatment with 20 mg of parecoxib reduces the severity of propofol injection pain significantly but does not reduce frequency compared with the control group.