One hundred seventy-six patients (ASA physical status I or II) presenting for elective surgery were randomly allocated into six study groups to compare the incidence of
propofol-induced
pain after pretreatment with different doses of
ephedrine as compared with
lidocaine. Patients in Group P (
n = 30) received saline placebo; patients in Group L (
n = 30) received 2%
lidocaine 40 mg; patients received
ephedrine 30 microg/kg (Group E30, n = 28), 70 microg/kg (Group E70,
n = 30), 110 microg/kg (Group E110,
n = 30), and 150 microg/kg (Group E150, n = 28), respectively, followed 30 s later by
propofol 2.5 mg/kg. A blinded anesthesiologist asked the patient to evaluate the
pain score (verbal rating scale and
face pain scale). The incidence and intensity of
pain was less in the
lidocaine and
ephedrine groups than in the placebo group (P < 0.01). Before tracheal intubation, the arterial blood pressure was decreased in the P and L groups, and after intubation, hemodynamics were increased in the E110 and E150 groups, respectively (P < 0.05). We concluded that pretreatment with a small dose of
ephedrine (30 and 70 microg/kg) reduced the incidence and intensity of
propofol-induced
pain with a lesser decrease in arterial blood pressure than from
propofol alone in
lidocaine pretreatment.
IMPLICATIONS:
Propofol is a widely used IV
anesthetic for the induction of
anesthesia, but it often causes local
pain when administered into peripheral veins. A small dose of
ephedrine reduces the incidence and intensity of the
pain without significant adverse hemodynamic effects during induction.