Evaluation of efficacy of low dose IV ketamine for prevention of pain associated with IV propofol injection

Abstract

Propofol is a widely used intravenous anaesthetic that is known to cause distressing local pain at the site of injection. Ketamine pretreatment is one of the methods proposed to attenuate Propofol injection pain due to its local anaesthetic properties.The present study was undertaken to evaluate the efficacy of low dose (100 mcg/kg) I.V. Ketamine in decreasing I.V. Propofol injection pain by using McCrirrick and Hunter scale.72 adult patients of ASA Physical status 1 and 2 of either sex undergoing elective surgical procedure under general anaesthesia were randomly allocated into two groups.Group- A (n=36): Pre-treatment with Ketamine 100µg/kg (1ml) and Group- B (n=36): pre-treatment with 0.9% Normal Saline (1ml).Comparison between group A and group B using McCrirrick and Hunter Evaluation Scale at 5,10 and 15 seconds intervals were statistically highly significant (p value<0.0001). None of the patients in group A experienced moderate or severe pain at all 3 intervals as compared to group B. McCrirrick and Hunter evaluation score mean values were also highly significant at all time intervals between both the groups. Hemodynamic parameters, EtCO and SpO were comparable between two groups. There was no incidence of any adverse effects in both the groups. I.V. Ketamine in a dose of 100mcg/kg with tourniquet as pretreatment before Propofol was useful in significantly reducing the incidence and severity of pain without any adverse haemodynamic effect.