Effect of intravenous tramadol, acetaminophen in attenuating pain on propofol injection: Comparison with lignocaine: A randomized, Double-blind, controlled study

Abstract

Objectives: Distress and pain due to propofol injection is a very common finding. The aim of our study was to assess the efficacy with lignocaine, tramadol, and acetaminophen pretreatment to alleviate the propofol pain. Materials and Methods: Ninety American Society of Anesthesiology (ASA) I and II adults, scheduled for various elective surgical procedures under general anesthesia, were included in the study. They were randomly divided into three groups with 30 patients in each group. Group A received pretreatment with intravenous (IV) lignocaine, group B received IV tramadol, and group C received IV acetaminophen. One-fourth of the total calculated induction dose of propofol was administered over a period of 5 s. The patients were asked about the pain on injection. The intensity of pain was assessed using verbal rating score. A score of 0–3, which corresponded to no, mild, moderate, and severe pain was recorded. Categorical and continuous variables were compared between the groups using Chi-square test and analysis of variance (ANOVA) test, respectively. Post hoc analysis was performed using Bonferroni test. Verbal rating scale (VRS), an ordered categorical variable, was compared between the groups using Wilcoxon signed-rank test. A P value of <0.05 was considered significant. Results: All the three drugs reduced the incidence and intensity of pain on propofol injection but the order of efficacy in attenuation of pain on the propofol injection was lignocaine > tramadol = acetaminophen. Conclusion: Both tramadol and acetaminophen were clinically equivalent to lignocaine in their potency to decrease the incidence of propofol pain.