A comparitive study of cisatracurium and normal saline pre-treatment with tourniquet for reduction of propofol injection pain

Abstract

Introduction: Pain is a common adverse event associated with propofol injection and pharmacological and nonpharmacological interventions to reduce propofol injection pain have been attempted with varying success. Aims: The present study was a randomized control study which aimed to assess the efficacy of pre-treatment with cisatracurium with venous occlusion for prevention of pain associated with propofol injection. Materials and methods: The total sample size was 60 patients who were randomly allotted into two groups; Group A: Cisatracurium (N=30) and Group B: Control(normal saline) (N=30). Pretreatment drug in each group was administered in tourniquet occluded veins followed by release of tourniquet after 30s and delivery of propofol. Pain scores were evaluated and expressed using a four-point scale. Each patient’s highest pain score were documented. Adverse effects were noted. Adverse effects at the injection site (pain, oedema, wheal, inflammation) were assessed for 24h after surgery. Results: The patients in both groups were comparable with regards to age ,gender weight and ASA status. The incidence of pain associated with propofol injection was found to be significantly less in patients in cisatracurium group as compared to the control group. The severity of pain associated with propofol injection was found to be significantly less in patients in cisatracurium group as compared to the control group. Changes in hemodynamic parameters were transient all the patients and no significant variations in hemodynamic parameters were observed in both groups under study. No adverse effects (immediate, after 24 h) were observed in any of the patients in both groups under study. Conclusion: Pretreatment with cisatracurium in the dose of 0.15 mg/kg in veins occluded by tourniquet was found to be effective in significantly reducing both the incidence and severity of pain induced by propofol injection (POPI) without any significant complications in patients with propofol induced general anaesthesia.