Abstract
Background: Propofol formulation containing long chain triglycerides (LCT) elicits severe pain on intravenous injection. Newer formulation of propofol containing combination of medium and long chain triglycerides (MCT/LCT;50:50) with less concentration of free propofol may be beneficial in this aspect. Methods: This prospective, randomized, double blind study included 116 ASAI/II adult patients undergoing short surgical procedures under general anesthesia. Patients in group M received 3 cc of MCT/LCT propofol (Fresofol 1%, Fresenius Kabi) and group L received LCT propofol (Diprivan 1%, Astrazeneca), both over 3 seconds (@1cc/sec to assess pain on injection using the VRS score. Induction time and requirement of additional dose of propofol was also noted. Heart rate (HR) and mean arterial pressure (MAP) were recorded at baseline, post intubation and 1, 3, 5 and 10 minutes thereafter. Serum triglyceride levels were measured 24 hours post-surgery and compared to preoperative levels. Results: Group M reported reduced pain score after IV propofol injection (1.37+2.40 vs 2.60+2.93) along with overall less incidence of pain (34.5% vs 53.4%). No difference was found in preoperative and 24 hours postoperative serum triglyceride levels in both groups. Three patients in group L developed thrombophlebitis as compared to one in group M. Induction time and hemodynamics were similar in both groups. Conclusion: MCT/LCT propofol produces less pain on intravenous injection. However, both formulations did not increase serum triglyceride levels after single induction dose. Keywords: Propofol, Anesthesia, Triglycerides, Long chain, Medium chain
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