Effectiveness of low-dose ketamine versus lignocaine pre-treatment to prevent propofol injection pain and hemodynamic instability in adult elective surgical patients at Tikur Anbessa specialized hospital, 2022: A prospective observational cohort study

Abstract

BackgroundPropofol is the most commonly used general anesthesia induction agent. It has injection pain and hemodynamic changes as a major drawback. These side effects are clinically undesirable because they can cause agitation and hinder the smooth induction of anesthesia. Determining the best method to reduce this effect is paramount important. This study aimed to compare the effectiveness of low dose ketamine versus lignocaine pre-treatment to prevent propofol injection pain and hemodynamic changes among study participants. MethodsAn institutional prospective cohort study was conducted on 82 (n1 = n2 = 41) adult elective surgical patients who took general anesthesia induction by propofol at our hospital from 01-Jan-2022 to30 Mar-2022. A systematic random sampling technique was used to select study participants. The pain was scored using a verbal rating scale and mean arterial pressure, heart rate and oxygen saturation was recorded during induction using a questionnaire. An independent samples t-test or chi-square test were used as appropriate. A P-value of < 0.05 was considered as statistically significant. ResultsTwo groups of 41 (LDK = low dose ketamine = Ld = Lignocaine = 41) patients were studied and the incidence of pain after pre-treatment with Low-dose ketamine (4.9%) group was significantly lower than lignocaine (22%) group (p = 0.023). The mean pain score after pre-treatment with low-dose ketamine group was significantly lower than the lignocaine group (p = 0.024). However, there was no statistically significant difference in heart rate, mean arterial pressure, and oxygen saturation (SpO2) between the groups. Conclusion and recommendationPre-treatment with a low dose of ketamine significantly reduces the incidence of propofol injection pain. We recommend its routine use before propofol injection ,and a multi-center more controlled study.