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Title: Comparing the Pretreatment with Lignocaine 40 mg and Fentanyl 100 ug as an Adjuvant for Preclusion of Pain Associated with Intravenous Propofol Injection
Authors: Syed Adnan Alam, Rashid Ullah Khan, Muhammad Bilal, Khurram Liaqat, Afia Rahna, Javed Iqbal
Journal: Journal of Islamabad Medical and Dental College (JIMDC)
Publisher: Healers Educational Society
Country: Pakistan
Year: 2023
Volume: 12
Issue: 3
Language: English
DOI: 10.35787/jimdc.v12i3.1048
Abstract
Background: Propofol (2,6-di-isopropylphenol) is one of the most favored drugs used for induction of anesthesia. Pain on injection is a common problem. Various methods have been tried to alleviate this pain but with conflicting results.
Objective: To compare effectiveness of lignocaine versus fentanyl in patients receiving propofol for general anesthesia in population of Pakistan who come to PIMS hospital in Islamabad.
Materials and Methods: 120 participants of either sex, between 18 and 40 years of age, belonging to ASA physical status I and II, undergoing elective surgery under general anesthesia, were randomized into two equal groups of 60 participants. They received, intravenously, either lignocaine 2 ml (20 mg/ml )or fentanyl 2 ml (50 mcg/mL) as a pretreatment before propofol injection.
Results: The efficacy of lignocaine as a pretreatment drug injection was higher (96.7%) compared to fentanyl (85.0%). In the lignocaine group, 2.3% of the participants experienced pain as compared with 15% in the fentanyl group (P<0.05).
Conclusion: Compared with fentanyl, lignocaine pretreatment was more effective in preventing pain on propofol injection.
KEY WORDS: Comparison, Fentanyl, LIgnocaine, Propofol, Pain.
To evaluate the relative efficacy of lignocaine and fentanyl as pre-treatments for reducing pain associated with intravenous propofol injection in patients undergoing general anaesthesia.
A randomized control trial was conducted with 120 patients (18-40 years old, ASA physical status I and II) randomly assigned to two groups of 60. Group A received 40 mg of 2% lignocaine intravenously, and Group B received 100 µg of fentanyl intravenously, as pre-treatment before propofol injection. Pain was assessed by an observer based on facial expressions. The McNemar chi-square test was used for efficacy evaluation.
graph TD;
A["Patient Recruitment 120 patients, 18-40 yrs, ASA I/II"] --> B["Random Assignment"];
B --> C["Group A: Lignocaine 40 mg IV Pre-treatment"];
B --> D["Group B: Fentanyl 100 µg IV Pre-treatment"];
C --> E["Propofol Injection"];
D --> E;
E --> F["Pain Assessment Facial Expressions"];
F --> G["Data Analysis McNemar Chi-Square Test"];
G --> H["Conclusion"];
The study supports the superiority of lignocaine over fentanyl in mitigating propofol injection pain, aligning with some previous research. The use of a tourniquet to occlude venous circulation provided a model to examine peripheral drug actions. Factors like vein size, injection speed, and propofol formulation could influence pain incidence.
Lignocaine (96.7%) was more effective than fentanyl (85.0%) in reducing pain associated with propofol injection (P<0.05). Only 2.3% of participants in the lignocaine group reported pain, compared to 15% in the fentanyl group.
Pre-treatment with 40 mg of 2% lignocaine is more successful in reducing discomfort during propofol injection compared to 100 µg of fentanyl. The study recommends using lignocaine pre-treatment and advises against using fentanyl at the tested dose for this purpose.
* Sample Size: The study involved 120 participants, divided into two equal groups of 60.
* Lignocaine Efficacy: Lignocaine pre-treatment showed 96.7% efficacy in reducing pain.
* Fentanyl Efficacy: Fentanyl pre-treatment showed 85.0% efficacy in reducing pain.
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