A study to assess the effect of pretreatment with intravenous palonosetron in preventing pain on propofol injection

Authors

  • Nethra Surhonne Department of Anaesthesia, Bangalore Medical College and Research Institute, Bangalore, India https://orcid.org/0000-0002-5998-2884
  • Chaithali Hebri Department of Anaesthesiology and Critical Care, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • Sudheesh Kannan Department of Anaesthesia, Bangalore Medical College and Research Institute, India https://orcid.org/0000-0002-3341-538X

DOI:

https://doi.org/10.20883/medical.e874

Keywords:

propofol, pain on injection, palonosetron

Abstract

Background. Propofol is widely used for induction and maintenance of anaesthesia and possesses many characteristics of an ideal intravenous anaesthetic agent. It is known to cause severe, sharp, stinging, or burning pain on injection, which is considered unacceptable as it can cause agitation and interfere with the smooth induction of anaesthesia. In this study, we compare palonosetron and normal saline for decreasing pain on injection of propofol during intravenous induction of anaesthesia.

Material and methods. One hundred adult patients belonging to ASA physical status I or II, scheduled for elective surgeries under general anaesthesia, were selected and randomly allocated to two groups. Group P received an injection of palonosetron, and Group S received an injection of regular saline as a pretreatment before the propofol injection. Patients were assessed for pain on propofol injection. Haemodynamic parameters and electrocardiography were recorded at the following points of time: prior to induction, after pretreatment, induction, and half-hourly during the surgery.

Results. Comparing pain during propofol injection, 32% of the palonosetron group and 4% of the regular saline group did not experience pain; 54% of the palonosetron group and 20% of the regular saline group suffered mild pain; 12% of the palonosetron group and 48% of the regular saline group developed moderate pain; 2% of the palonosetron group and 28% of the regular saline group experienced severe pain.

Conclusions. Pretreatment with palonosetron 0.075 mg reduced the incidence and severity of propofol-induced pain on injection, with the added advantage of decreased postoperative nausea and vomiting without significant haemodynamic changes.

Downloads

Download data is not yet available.

References

Vuyk J, Sitsen E, Reekers M. Intravenous Anesthetics. In Miller RD (ed). Miller’s Anesthesia. Vol 1, 8th edition. Philadelphia, Churchil Livingstone, Elsevier Inc, 2015; pp. 822-832.

Marik PE. Propofol: therapeutic indications and side-effects. Curr Pharm Des. 2004;10(29):3639-49. doi: 10.2174/1381612043382846. PMID: 15579060.

Jalota L, Kalira V, George E, Shi YY, Hornuss C, Radke O, Pace NL, Apfel CC; Perioperative Clinical Research Core. Prevention of pain on injection of propofol: systematic review and meta-analysis. BMJ. 2011 Mar 15;342:d1110. doi: 10.1136/bmj.d1110. PMID: 21406529.

Ambesh SP, Dubey PK, Sinha PK. Ondansetron Pretreatment to Alleviate Pain on Propofol Injection: A Randomized, Controlled, Double-Blinded Study. Anesthesia & Analgesia. 1999 July;89(1):197-199. doi: 10.1213/00000539-199907000-00035.

Doenicke AW, Roizen MF, Rau J, Kellermann W, Babl J. Reducing Pain During Propofol Injection: The Role of the Solvent. Anesthesia & Analgesia. 1996 March;82(3):472-474.

Singh DK, Jindal P, Singh G. Comparative study of attenuation of the pain caused by propofol intravenous injection, by granisetron, magnesium sulfate and nitroglycerine. Saudi J Anaesth. 2011;5:50-4. doi: 10.4103/1658-354X.76511.

McCrirrick A, Hunter S. Pain on injection of propofol: The effect of injectate temperature. Anaesthesia. 1990;45:443-4. doi: 10.1111/j.1365-2044.1990.tb14329.x.

Picard P, Tramer MR. Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg. 2000;90:963-9. doi: 10.1213/00000539-200004000-00035.

Ryu HB, Kim SJ. Analgesic effects of palonosetron in the intravenous propofol injection. Korean J Anesthesiol. 2014;66(2):99–104. doi: 10.4097/kjae.2014.66.2.99.

McLeod B, Boheimer N. Propofol ('Diprivan') infusion as main agent for day case surgery. Postgrad Med J. 1985;61 Suppl 3:105-7. PMID: 3932992.

Reves JG, Glass PSA, Lubarsky DA, Mcevo MD, Martinez-Ruiz R. Intravenous Anaesthetics. Miller’s Anaesthesia 7th edition. Philadelphia: Churchill livingstone, Elsevier Inc, 2010; pp. 719-768. doi: https://doi.org/10.1016/B978-0-443-06959-8.00026-1.

Gehan G, Karoubi P, Quinet F, Leroy A, Rathat C, Pourriat JL. Optimal dose of lignocaine for preventing pain on injection of propofol. Br J Anaesth. 1991 March;66(3):324-326. doi: https://doi.org/10.1093/bja/66.3.324.

Klement W, Arndt JO. Pain on injection of propofol: effects of concentration and diluent. Br J Anaesth. 1991 Sep;67(3):281-4. doi: 10.1093/bja/67.3.281.

El-Radaideh KM. [Effect of pretreatment with lidocaine, intravenous paracetamol and lidocaine-fentanyl on propofol injection pain. Comparative study. Rev Bras Anestesiol. 2007 Feb;57(1):32-8. English, Portuguese. doi: 10.1590/s0034-70942007000100004.

Ganta R, Fee JP. Pain on injection of propofol: comparison of lignocaine with metoclopramide. Br J Anaesth. 1992 Sep;69(3):316-7. doi: 10.1093/bja/69.3.316.

Memiş D, Turan A, Karamanlioglu B, Kaya G, Pamukçu Z. The prevention of propofol injection pain by tramadol or ondansetron. Eur J Anaesthesiol. 2002 Jan;19(1):47-51. doi: 10.1017/s0265021502000078.

Lee S, Park J, Woo S, Yeon J. Ondansetrone and lidocaine: Comparative analysis for pain on injection of microemulsion propofol: 1AP6–2. European Journal of Anaesthesiology. 2010 Jun 12;27(47):p 22.

Ryu HB, Kim SJ. Analgesic effects of palonosetron in the intravenous propofol injection. Korean J Anesthesiol. 2014 Feb;66(2):99-104. doi: 10.4097/kjae.2014.66.2.99. Epub 2014 Feb 28.

Singh TH, Devi NA, Arasu T, Rajkumar G, Devi LE, Singh NR. Effect of palonosetron pretreatment to attenuate the pain caused by propofol injection. J Med Soc. 2017 May-Aug;31(2):p 90-93. DOI: 10.4103/0972-4958.204817.

Lee KH, Rim SK, Lee JY, Lee SY, Lee SN, Lee EJ, Lee JH. Effects of pretreatment with intravenous palonosetron for propofol-remifentanil-based anesthesia in breast and thyroid cancer surgery: a double-blind, randomized, controlled study. Korean J Anesthesiol. 2014 Jul;67(1):13-9. doi: 10.4097/kjae.2014.67.1.13. Epub 2014 Jul 29.

Kang WJ, Hong SK, Keon SK. Effect of ondansetron and lignocaine on vascular pain associated with intravascular propofol injection. Korean J Anaesthesiol. 2004;46:393-396. doi: https://doi.org/10.4097/kjae.2004.46.4.393.

Helmers JH, Kraaijenhagen RJ, v Leeuwen L, Zuurmond WW. Reduction of pain on injection caused by propofol. Can J Anaesth. 1990 Mar;37(2):267-8. doi: 10.1007/BF03005485.

Memiş D, Turan A, Karamanlioğlu B, Kaya G, Pamukçu Z. The prevention of propofol injection pain by tramadol or ondansetron. European Journal of Anaesthesiology. 2002 January;19(1):47-51. doi: https://doi.org/10.1097/00003643-200201000-00007

Ahmed A, Sengupta S, Das T, Rudra A, Iqbal A. Pre-treatment with intravenous granisetron to alleviate pain on propofol injection: A double-blind, randomized, controlled trial. Indian J Anaesth. 2012 Mar;56(2):135-8. doi: 10.4103/0019-5049.96308.

Lee HY, Kim SH, So KY. Prevention of microemulsion propofol injection pain: a comparison of a combination of lidocaine and ramosetron with lidocaine or ramosetron alone. Korean J Anesthesiol. 2011 Jul;61(1):30-4. doi: 10.4097/kjae.2011.61.1.30. Epub 2011 Jul 21.

Gralla R, Lichinitser M, Van Der Vegt S, Sleeboom H, Mezger J, Peschel C, Tonini G, Labianca R, Macciocchi A, Aapro M. Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Ann Oncol. 2003 Oct;14(10):1570-7. doi: 10.1093/annonc/mdg417.

Downloads

Published

2023-12-07

Issue

Section

Original Papers

How to Cite

1.
Surhonne N, Hebri C, Kannan S. A study to assess the effect of pretreatment with intravenous palonosetron in preventing pain on propofol injection. JMS [Internet]. 2023 Dec. 7 [cited 2024 Nov. 4];92(4):e874. Available from: https://jmsnew.ump.edu.pl/index.php/JMS/article/view/874
Received 2023-06-16
Accepted 2023-08-30
Published 2023-12-07