Prevention of Propofol-induced Injection Pain by Intravenous Administration of Butorphanol or Tramadol_West China Medical Journal

Authors：

 YANYa-lan , YANGGuang , SuLi , XIANGRui ,  ZHANGLan

Department of Anesthesiology, Sichuan Orthopedic Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZHANGLan, Email: zlzxm@163.com

Keywords：

Butorphanol; Tramadol; Propofol injection pain; Intravenous injection; Intravenous drip

DOI：

10.7507/1002-0179.20150022

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Objective To compare the effect of pretreatment with butorphanol or tramadol for prevention of propofol-induced injection pain by intravenous injection or drip, in order to explore a safe and effective method. Methods We chose 150 patients of ASAⅠ-Ⅱundergoing elective surgery between October 2012 and March 2013 in Sichuan Orthopedic Hospital as the study subjects. They were randomly divided into five groups with 30 patients in each group:butorphanol injection and drip group (group BI and group BD), tramadol injection and drip group (group TI and group TD), control group (group C). Five minutes before anesthesia induction, patients in group BI, TI and C were respectively injected with butorphanol 2 mg, tramadol 100 mg, and saline; patients in group BD and TD were respectively injected with butorphanol 2 mg and tramadol 100 mg before receiving propofol (2.5 mg/kg) for 2 minutes. Assessment of pain during injection was done by using a four-point scale. Results The pre-injection pain incidence in group BI and TI was significantly higher than that in group BD, TD and C(P < 0.05), and it was significantly higher in group BI than group TI (P < 0.05). The incidence of propofol injection pain in group BI, BD, TI and TD were significantly lower than that in group C (P < 0.05), and it was the lowest in group BD (P < 0.05) followed by group BI (P < 0.05). The total rate of pain in group BD was only 6.67%, significantly lower than other groups (P < 0.05). Conclusions The pretreatment with butorphanol and tramadol by intravenous injection or drip can reduce the incidence of propofol injection pain. Pretreatment with butorphanol at 2 mg by intravenous drip is more effective, but should be closely observed to avoid adverse events.

Citation： YANYa-lan, YANGGuang, SuLi, XIANGRui, ZHANGLan. Prevention of Propofol-induced Injection Pain by Intravenous Administration of Butorphanol or Tramadol. West China Medical Journal, 2015, 30(1): 80-83. doi: 10.7507/1002-0179.20150022 Copy

1.	Nathanson MH, Gajraj NM, Russell JA. Prevention of pain on injection of propofol:a comparison of lidocaine with alfentanil[J]. Anesth Analg, 1996, 82(3):469-471.
2.	Kam E, Abdul-Latif MS, Mccluskey A. Comparison of propofol-lipuro with propofol mixed with lidocaine 10 mg on propofol injection pain[J]. Anaesthesia, 2004, 59(12):1167-1169.
3.	趙墨, 劉金鋒, 方先海, 等.利多卡因靜脈注射預防胃腸鏡檢查中丙泊酚注射痛[J].中國疼痛醫學雜志, 2009, 15(3):190.
4.	牛麗, 宣燕, 王江.利多卡因預防丙泊酚注射痛效果的Meta分析[J].中國循證醫學雜志, 2013, 13(9):1129-1136.
5.	賴慶利, 李秀澤, 李衛, 等.舒芬太尼預處理對丙泊酚注射痛的影響[J].四川醫學, 2008, 29(6):730-731.
6.	Honarmand A, Safari M. Prevention of propofol-induced injection pain by sufentanil:a placebo-controlled comparison with remifentanil[J]. Clin Drug Investig, 2008, 28(1):27-35.
7.	Iwata M, Inoue S, Kawaguchi M, et al. Ketamine eliminates propofol pain but does not affect hemodynamics during induction with double-lumen tubes[J]. J Anesth, 2010, 24(1):31-37.
8.	Agarwal A, Raza M, Dhiraaj S, et al. Pain during injection of propofol:the effect of prior administration of butorphanol[J]. Anesth Analg, 2004, 99(1):117-119.
9.	呂美紅, 聞慶平, 于維穎.預注布托啡諾對人工流產術中丙泊酚注射痛的影響[J].實用疼痛學雜志, 2012, 8(3):201-202.
10.	易峰.曲馬多對丙泊酚誘導性低血壓及注射痛的影響[J].基層醫學論壇, 2013, 17(25):3296-3298.
11.	徐廣民, 林濤, 范丹, 等.利多卡因與不同劑量曲馬多預處理緩解丙泊酚注射痛的效果比較[J].實用醫院臨床雜志, 2012, 9(1):97-99.
12.	曾睿峰, 唐巖峰, 何偉, 等.利多卡因、芬太尼和布托啡諾分別用于預防丙泊酚注射痛的療效觀察[J].海峽藥學, 2009, 21(10):103-106.
13.	Ressell GB, Graybeal JM. Hypoxiccp episodes of patients in a postanesthesthesia care unit[J]. Chest, 1993, 104(3):899.
14.	Canbay O, Celebi N, Arun O, et al. Efficacy of intravenous acetaminophen and lidocaine on propofol injection pain[J]. Br J Anaesth, 2008, 100(1):95-98.
15.	Ramsay M, Savege TM, Simpson B, et al. Controlled sedation with alphaxdone[J]. BMJ, 1974, 2(5920):656-659.
16.	Picard P, Tramer MR. Prevention of pain on injection with propofol:a quantitative systematic review[J]. Anesth Analg, 2000, 90(4):963-969.
17.	周木香, 謝敏, 李祥奎.氟哌利多和曲馬多預注在乳腺手術的超前鎮痛效果觀察[J].實用醫院臨床雜志, 2011, 8(5):131-132.

1. Nathanson MH, Gajraj NM, Russell JA. Prevention of pain on injection of propofol:a comparison of lidocaine with alfentanil[J]. Anesth Analg, 1996, 82(3):469-471.
2. Kam E, Abdul-Latif MS, Mccluskey A. Comparison of propofol-lipuro with propofol mixed with lidocaine 10 mg on propofol injection pain[J]. Anaesthesia, 2004, 59(12):1167-1169.
3. 趙墨, 劉金鋒, 方先海, 等.利多卡因靜脈注射預防胃腸鏡檢查中丙泊酚注射痛[J].中國疼痛醫學雜志, 2009, 15(3):190.
4. 牛麗, 宣燕, 王江.利多卡因預防丙泊酚注射痛效果的Meta分析[J].中國循證醫學雜志, 2013, 13(9):1129-1136.
5. 賴慶利, 李秀澤, 李衛, 等.舒芬太尼預處理對丙泊酚注射痛的影響[J].四川醫學, 2008, 29(6):730-731.
6. Honarmand A, Safari M. Prevention of propofol-induced injection pain by sufentanil:a placebo-controlled comparison with remifentanil[J]. Clin Drug Investig, 2008, 28(1):27-35.
7. Iwata M, Inoue S, Kawaguchi M, et al. Ketamine eliminates propofol pain but does not affect hemodynamics during induction with double-lumen tubes[J]. J Anesth, 2010, 24(1):31-37.
8. Agarwal A, Raza M, Dhiraaj S, et al. Pain during injection of propofol:the effect of prior administration of butorphanol[J]. Anesth Analg, 2004, 99(1):117-119.
9. 呂美紅, 聞慶平, 于維穎.預注布托啡諾對人工流產術中丙泊酚注射痛的影響[J].實用疼痛學雜志, 2012, 8(3):201-202.
10. 易峰.曲馬多對丙泊酚誘導性低血壓及注射痛的影響[J].基層醫學論壇, 2013, 17(25):3296-3298.
11. 徐廣民, 林濤, 范丹, 等.利多卡因與不同劑量曲馬多預處理緩解丙泊酚注射痛的效果比較[J].實用醫院臨床雜志, 2012, 9(1):97-99.
12. 曾睿峰, 唐巖峰, 何偉, 等.利多卡因、芬太尼和布托啡諾分別用于預防丙泊酚注射痛的療效觀察[J].海峽藥學, 2009, 21(10):103-106.
13. Ressell GB, Graybeal JM. Hypoxiccp episodes of patients in a postanesthesthesia care unit[J]. Chest, 1993, 104(3):899.
14. Canbay O, Celebi N, Arun O, et al. Efficacy of intravenous acetaminophen and lidocaine on propofol injection pain[J]. Br J Anaesth, 2008, 100(1):95-98.
15. Ramsay M, Savege TM, Simpson B, et al. Controlled sedation with alphaxdone[J]. BMJ, 1974, 2(5920):656-659.
16. Picard P, Tramer MR. Prevention of pain on injection with propofol:a quantitative systematic review[J]. Anesth Analg, 2000, 90(4):963-969.
17. 周木香, 謝敏, 李祥奎.氟哌利多和曲馬多預注在乳腺手術的超前鎮痛效果觀察[J].實用醫院臨床雜志, 2011, 8(5):131-132.

West China Medical Journal

Prevention of Propofol-induced Injection Pain by Intravenous Administration of Butorphanol or Tramadol

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