English

Abstract

BACKGROUND The incidence of pain on propofol injection varies between 28 – 90 % during induction and may be severe. Ramosetron has been proved efficacious in reducing propofol pain in adults but not in children, therefore we conducted this double blinded randomized controlled study to determine the effectiveness of ramosetron in attenuating propofol induced pain in children. The purpose of this study was to compare the effectiveness of injection ramosetron, a 5HT3 antagonist and lidocaine, the commonest drug for attenuation of pain caused by injection propofol. METHODS This is a randomised double-blinded study. Eighty children of American Society of Anaesthesiologist (ASA) grade I - II, aged 4 - 14 years, undergoing elective surgical procedures under general anaesthesia were randomly assigned to two groups of 40 each. Group PR received 6 µg/kg of ramosetron and Group PL received 0.2 mg/kg of 2 % lidocaine. After injection of study drug, occlusion of venous drainage was done manually by a trained assistant at mid-arm for 60 seconds. After releasing manual occlusion Injection propofol (1 %) 2 mg/kg was administered slowly over a period of 5 seconds. A four point scale was used to assess the severity of pain. The results were analysed by using unpaired student’s t - test and chi-square test/Fisher’s exact test. P value of < 0.05 was considered statistically significant. RESULTS The demographic characteristics were comparable in both groups. The incidence of no pain in Group PR and Group PL was 60 % (N = 24) and 65 % (N = 26) respectively which was comparable. The incidence of mild, moderate and severe pain was comparable in both groups. The overall incidence of propofol injection pain in group PL and group PR was 35 % and 40 % respectively (P = 0.862). CONCLUSIONS Intravenous ramosetron at a dose of 6 µg/kg can effectively attenuate the propofol induced pain comparable to 0.2 mg/kg of lidocaine in children. KEYWORDS Children, Lidocaine, Propofol Induced Pain, Ramosetron