Abstract
Propofol, an intravenous anesthetic widely used for general anaesthesia cause severe pain in most of people. The aim of present study is to know the anti nociceptive effect of clonidine infusion with that of control (Normal saline) infusion immediately prior to propofol injection in alleviating Propofol injection pain (PIP). The present study was a randomized controlled study where in following the approval of the hospital's ethics Committee, 60 consenting adult patients were randomly divided into two groups A and B (n = 30) to receive 20 ml of normal saline as control and 0.5 μg/kg of clonidine diluted in 20 ml of normal saline respectively. The propofol injection pain was assessed according to the Mc Cririck and Hunter scale. The 27 patients in control group expressed pain compared to 18 patients in clonidine Group. In participants receiving clonidine 12(40%) were determined to be in Grade 0 according to Mc.Crick and Hunter Pain Scale,12(40%) patients were determined to be in Grade 1 and 5(16.67%) participants were in grade 2 followed by 1(3.33%) patients were detrmined to be in Grade 3according to Mc.Crick and Hunter Pain Scale. There is no significant difference between heart rate, Mean Arterial Pressures and haemodynamic side effects in both groups. Pre treatment with0.5 µg/kg of clonidine is effective in alleviating incidence and severity of propofol induced pain, did not cause significant hemodynamic adverse side effects.
Keywords: Propofol, Clonidine, Pain, Anaesthesia, Prevention, haemodynamic changes.
References
- Marik PE; Propofol: therapeutic indications and side-effects. Curr Pharm Des2004;10:3639-49
- Jalota L, Kalira V, George E, Shi YY, Hornuss C, Radke O, Apfel CC; Prevention of pain on injection of propofol: systematic review and metaanalysis.Bmj, 2011; 342.
- Macario A, Weinger M, Truong P, Lee M; Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expertanesthesiologists. Anesth Analg, 1999; 88:1085–1091.
- Arndt JO, Klement W; Pain evoked by polymodal stimulation of hand veins in humans. J Physiol,1991; 440: 467–478.
- Briggs LP, Clarke RSJ, Dundee JW, Moore J, Bahar M, Wright PJ; Use of di-isopropyl phenol as main agent for short procedures. British journal of anaesthesia, 1981; 53(11): 1197-1202.
- Nakane M, Iwama H; A potential mechanism of propofol-induced painon injection based on studies using nafamostat mesilate. Br J Anaesth, 1999; 83:397-404.
- Doenicke AW, Roizen MF, Rau J, Kellermann W, Babl J; Reducing pain during propofol injection: The role ofthe solvent. Anesth Analg, 1996; 82:472–474.
- Ahmed A, Sengupta S, Das T, Rudra A, Iqbal A. Pre-treatment with intravenous granisetron to alleviate pain on propofol injection: A double-blind, randomized, controlled trial. Indian J Anaesth. 2012; 56:135–8.
- Yoshikawa T, Wajima Z, Ogura A, Inoue T, Ogawa R. Orally administered clonidine significantly reduces pain during injection of propofol. Br J Anaesth. 2001;86:874–6.
- Nakane M, Iwama H; A potential mechanism of propofol-induced painon injection based on studiesusing nafamostat mesilate. Br J Anaesth, 1999; 83: 397-404
- Ambesh SP, Dubey PK, Sinha PK; Ondansetron pre treatment to alleviate pain on propofol injection:A randomized, controlled, double-blindedstudy. Anesth Analg, 1999; 89: 197–199.
- Briggs LP, Clarke RSJ, Dundee JW, Moore J, Bahar M, Wright PJ; Use of di-isopropyl phenol as main agent for short procedures. British journal of anaesthesia, 1981; 53(11): 1197-1202.
- Stokes DN, Robson N, Hutton P; Effect of diluting propofol on the incidence of pain on injection and venous sequelae. Br J Anaesth, 1989; 62: 202–203
- Jamadarkhana S, Gopal S. Clonidine in Adults as a Sedative Agent in the Intensive Care Unit. Journal of Anaesthesiology, Clinical Pharmacology 2010;26(4):439-445.
- Martin Sasada, Susan Smith. 3rd. Oxford (UK): Oxford University Press; 2003. Drugs in Anaesthesia and Intensive care; pp. 76–77.
- Maze M, Tranquilli W. Alpha 2 adrenoceptor agonists: defining the role in clinical anaesthesia. Anesthesiology. 1991;74:581–605.
- Ishiyama T, Kashimoto S, Oguchi T, Furuya A, Fukushima H, Kumazawa T. Clonidine-ephedrine combination reduces pain on injection of propofol and blunts hemodynamic stress responses during the induction sequence. J Clin Anesth 2006;18:211-5.
Corresponding Author
Dr Somavarapu Sarwesh Kumar
Assistant Professor, Kamineni Institute of Medical Sciences and Research Center,
Hyderabad, Telangana State, India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.