To Compare the Efficacy of Pretreatment with Three Different Doses of Intravenous Thiopentone to Alleviate Local Pain on Propofol Injection in Patients Undergoing Procedures under General Anaesthesia: A Prospective Double Blind Randomized Study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 3
Abstract
Abstract: Our aim was to compare three different doses of thiopentone pretreatment (0.25mg/kg, 0.5mg/kg, 0.75mg/kg) in alleviating local pain on propofol injection and to look for any adverse outcomes on thiopentone pretreatment. 138 patients were allocated into three different groups (A, B, C) of 46 each using random number table method. Patients in group A, B and C received 0.25mg/kg, 0.5mg/kg and 0.75mg/kg thiopentone respectively, diluted in 2ml normal saline after occluding the venous drainage by applying tourniquet at middle of forearm. After 60 seconds, tourniquet was removed and 1/4th of total calculated dose of propofol (0.625mg/kg) was administered slowly over 5 seconds. Pain was graded using a four-point verbal rating scale and sedation using Ramsay sedation scale. Within 24 hours after surgery, the injection site was checked for pain, edema, and wheal and flare response. We found that there were statistically significant differences in incidence (p value < 0.0001) as well as severity (p value = 0.001) of pain on propofol injection among the groups. Our study also showed significant variation in incidence and severity of pain in females compared to males (p value = 0.03). Significant differences were also observed in Ramsay sedation scores among the groups (p value < 0.0001). However, no significant difference was found in pain score with regards to age (p value = 0.72) and no injection site reactions as pain, edema, wheal, flare were observed within 24hours of procedure. Our conclusion was that pretreatment with 0.75mg/kg thiopentone is highly effective in attenuating the incidence and severity of pain on propofol injection. Keywords: Propofol, thiopentone, tourniquet, four point verbal rating scale, Ramsay sedation score.
Authors and Affiliations
Dr. Abhas Chandra Dash, Dr. Rajeev Lochan Tiwari, Dr. Jyotsna Bhargava
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