Comparison of effect of low dose ketamine and lignocaine pre-treatment in prevention of pain on propofol injection during general anesthesia for elective surgeries

Aravind A, Arun Kumar R and Kavitha R

Published on: 2022-12-29


Background: Pain on propofol injection stands seventh most important issue in daily practice of clinical anesthesia as per American anesthesiologist. The nature of pain in propofol injection is extremely sharp aching or burning and the patient usually remembers it as an unpleasant sensation though it does not cause a serious complication.

 Aim and Objectives: The primary objective of the study was to compare the effect of low dose ketamine and 2% lignocaine pre-treatment in preventing pain on propofol injection (POPI) with verbal rating scale for pain response. The secondary objective was to compare the hemodynamic changes by low dose ketamine and 2% lignocaine when used in preventing pain on propofol injection.

Methodology: This was a prospective randomized double blinded trial study donein 60 patients, categorized as Group K who received ketamine 100mcg/kg and Group L received lignocaine 0.5 mg/kg intravenously in 100ml saline infusion and after 15 seconds 1% propofol injected intravenously at 2mg/kg over 30 seconds. Following the fixed dose administration of propofol, blinded anesthesiologist will ask the patient to rate the sensation of pain using [1] verbal rating scale. Two-sided unpaired t-test and chi-square test was applied to analyse the data and p-value less than 0.05 was considered as statistical significance.

Results: 13.3% participants in group K experienced pain score of 1 and 6.7% participants in group L experienced pain score of 1. 3.3% individuals in group L experienced pain score of 3 and the statistical insignificance were noted with regard to pain response in both the groups. Hemodynamic variables including heart rate, mean arterial blood pressure and oxygen saturation had no statistical significance following 1,3 and 5 minutes after administration of fixed dose of propofol. Conclusion : We conclude from our study that pre-treatment with either 2% lignocaine 0.5 mg/kg or ketamine 100µg/kg were significantly effective in attenuating the pain response and decreasing the severity of pain during propofol injection and there was no hemodynamic variations and complications encountered in both the groups.