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Evaluation of the effect of cold normal saline as a carrier fluid in reducing propofol induced pain

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Original Article

Author Details : Murali Shankar Bhat, Sheba Cherian, Raghavendra R Huchchannavar, Chethana Bolanthakodi*

Volume : 11, Issue : 4, Year : 2024

Article Page : 453-457

https://doi.org/10.18231/j.ijca.2024.085

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Abstract

Background: Pain or discomfort during intravenous injection is a common unwanted result of Propofol, and can lead to dissatisfaction. Various methods are used to reduce ‘pain on propofol injection’ (POPI), among which mixing lignocaine with propofol is commonly used. However mixing lignocaine destabilises propofol, leading to reduced anaesthetic properties of propofol, warranting the use of other methods. Cold temperatures reduce nerve conduction velocity resulting in decreased pain signal transmission and have vasoconstrictive properties which reduce local tissue irritation, potentially minimizing pain.
Aim and Objective: To evaluate cold normal saline (at 4°C) as carrier fluid in reducing POPI compared to normal saline at room temperature, with a primary objective of assessing the incidence and severity of pain using a pain score and a secondary objective of assessing postoperative recall in both the groups.
Materials and Methods: A single-blinded prospective randomized controlled trial was conducted involving 76 patients undergoing general anaesthesia for elective surgeries. The patients were randomly assigned to two groups: Group C received cold saline (at 4°C) and Group R received room temperature saline as carrier fluids during propofol administration. Pain during injection was recorded using pain score, Heart rate changes before and after propofol administration, and Postoperative recall of injection pain was assessed.
Result: The incidence of pain was significantly lower in Group C (52.6%) compared to Group R (81.57%) (p=0.007). Group R had a higher severity of pain, with more patients experiencing moderate to severe pain. Group R also showed an increase in heart rate (3.46%) compared to Group C (0.27%) (p=0.027). Postoperative recall of injection pain was more frequent in Group R than in Group C.
Conclusion: Cold normal saline as a carrier fluid (at 4C) effectively reduces pain associated with propofol injection. This technique helps to enhance patient comfort and satisfaction, making it a valuable addition to clinical practice.
 

Keywords: Pain on propofol injection (POPI), Intravenous induction agent, Cold normal saline, Pain incidence, Postoperative pain recall, Degree of pain.

How to cite : Bhat M S, Cherian S, Huchchannavar R R, Bolanthakodi C, Evaluation of the effect of cold normal saline as a carrier fluid in reducing propofol induced pain. Indian J Clin Anaesth 2024;11(4):453-457

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