Prevention of Propofol-Induced Injection Pain By Ketamine Pretreatment.

Short Communication


Masoud A. Lfeituri ¹, Abdul Mutaleb B. Issa ², Mounir K. Afifi ³

1-Department of Surgery, Unit of Anaesthesia and Intensive Care, Faculty of Medicine, Garyounis University, Benghazi, Libya. 2-Department of Anaesthesia, Tripoli Medical Centre. Tripoli, Libya. 3-Department of of Anaesthesia, Alexandria University, Alexandria, Egypt

JMJ Vo1. 8 No.4 (Winter) 2008:296-298


Background: A disadvantage of propofol is a high incidence of injection pain (up to 90%), which is sometimes very distressing to patients. Pretreatment with ketamine and lignocaine have been tried in different studies to reduce this pain. Aim of the study: We aimed to further investigate whether pretreatment with a small dose of IV ketamine reduces propofol-induced injection pain in the same magnitude as does lignocaine pretreatment. Patients & Methods: Seventy five of ASA I or II female adult patients scheduled for elective general surgical procedures were enrolled in the study. Patients were divided into three groups: saline group (n=25) received 2ml of 0.9% isotonic saline; lidocaine group (n=25) received 2ml of 1% lidocaine, and ketamine group (n=25) received 2ml of 1% ketamine hydrochloride. Then, 1% propofol (2.5 mg/kg) was injected. Pain was evaluated by a scale of 4 grades: None (no pain), mild, moderate, and severe pain. Results: The incidence of injection pain was 68% (17 patients), 8% (2 patients), and 16% (4 patients) in the saline, lidocaine and ketamine groups respectively. The total pain score (total patients with pain) differences between the control saline group and the other two groups were statistically significant (P<0.0001), but not between the lidocaine and ketamine groups. Pain intensity was significantly less in the lidocaine and ketamine groups as compared to the saline group (P<0.05). Conclusion: Small IV doses of either lidocaine or ketamine are similarly effective in reducing incidence and severity of the propofol-induced injection pain. Keywords: Propofol, Injection pain, Pretreatment, Lidocaine, Ketamine. Link/DOI: