Comparison of Lidocaine and Tramadol Premedication in Attenuating Propofol Injection Pain at Comprehensive Specialized Teaching Hospital of Ethiopia: A comparative Cross-Sectional Study

Abstract

Background: Propofol is a widely used drug for the induction of anesthesia and often causes severe, sharp, stinging, or burning pain on the injection that can be distressing to the patient. Premedication with opioids, lidocaine, slow injection, and using a large vein for injection has been tried to combat the problem though there is controversy. The study aims to assess the effectiveness of intravenous lidocaine and Tramadol in reducing the incidence and severity of pain on Propofol injection for the adult elective surgical patient in Tikur Anbessa Comprehensive Specialized Teaching Hospital, Addis Ababa Ethiopia from February 1, 2018-March 30, 2018. G.C. Materials and Methods: Comparative cross-sectional study design was employed on a sample of 156 patients divided into two groups of 78. Participants who were 18-60 years old, underwent general anesthesia, and induced with Propofol as well as premedicated with lidocaine or Tramadol were included in the study. Patient interviews, chart review, and pretested questionnaires were employed for data collection. Collected data was analyzed using SPSS version 23. Mann-Whitney U test and chi-square test were used to compare continuous and categorical variables respectively. P-value<0.05 was considered as statistically significant.. Result: The incidence of propofol injection pain after pretreatments with lidocaine (n=78) was 23.1% and the incidence of propofol injection pain after pretreatments with tramadol (n=78) was 34.6% with a p-value of 0.112. The severity of pain expressed in the median and interquartile range of NRS score was 0 (0-2.25) in lidocaine and 0 (0-3) in tramadol group which was comparable between lidocaine and tramadol group with no statistically significant difference between two groups with (P=0.669). Conclusion: Both Lidocaine and tramadol might reduce the incidence and severity of Propofol injection pain. Anesthetists should consider the use of both lidocaine and tramadol as pretreatment for the attenuation of propofol injection pain.