Prevention of propofol injection pain: the effectiveness of tramadol pretreatment

Abstract

Propofol is a popular intravenous anesthetic induction agent, and pain on injection of propofol is a common problem. The purpose of this study was to compare the effects of pretreatment with two different dozes of tramadol and lidocaine mixed with propofol on incidence and severity of the pain produced by intravenous injection of propofol. We conducted a prospective, randomized, double-blind trial on eighty patients undergoing elective surgery. Group L, lidocaine 20 mg added to 180 mg propofol; Group T50, tramadol 50 mg 10 minutes prior to propofol; Group T100, tramadol 100 mg 10 minutes prior to propofol; Group P, plecebo (normal saline). The indicence of pain in Group P was 75 %. Group T100 and Group L had a significantly lower incidence of pain than Group P (p<0.05). There was no significant difference in the incidence of pain between the Group P and T50 (75 % and 50 %, respectively). Fourty-nine percent of the patients (18/37) who experienced pain at induction had recall of that pain in the recovery room (10 patients in Group P, 5 patients in Group T50 and 3 patients in Group T100). In Group L, none of the patients had recall of that pain in the recovery room. There was significant difference in the recall of that pain in the recovery room among Group P and other groups (p<0.0001). In conclusion, we have shown that pretreatment with tramadol 100 mg is as effective as lidocaine mixed with propofol in reducing the incidence and severity of pain during injection of propofol. But pretreatment with tramadol 50 mg is less effective than other treatments methods.