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The effect and optimal dose of sufentanil in reducing injection pain of microemulsion propofol
Dong Hun Chung1, Nan Sook Kim, Mi Kyoung Lee
1Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Korea.
Background:
Propofol is used as an induction and maintenance agent for general anesthesia but it can cause adverse reactions like hyperlipidemia, growth of microorganisms, and pulmonary embolisms. Microemulsion propofol was developed to avoid these side effects but incidence and severity of pain on injection is higher than with lipid emulsion propofol. We aimed to compare the effects of sufentanil in analgesic doses for reducing the injection pain of microemulsion propofol.
Methods:
The candidates included eighty patients, 19-60 years old and ASA I-II. They were randomly classified into four groups and pretreated with normal saline, sufentanil 0.1 µg/kg, 0.2 µg/kg or 0.3 µg/kg before injection of microemulsion propofol. Five minutes after receiving pretreatment drug, 2 mg/kg of microemulsion propofol was injected and VAS was recorded.
Results:
There were no significant differences in the incidence of injection pain among the groups. Severity of injection pain was significantly lower in the sufentanil 0.3 µg/kg group than normal saline and sufentanil 0.1 µg/kg group. Significant differences in blood pressure and heart rate were observed in sufentanil groups only after endotracheal intubation. One patient each in sufentanil 0.1 µg/kg and 0.3 µg/kg group experienced mild cough, one from sufentanil 0.3 µg/kg group experienced dizziness and another showed signs of hypoxia. One patient each in normal saline and sufentanil 0.1 µg/kg group showed clinical symptoms of phlebitis in the injection area.
Conclusions:
Pretreatment with sufentanil 0.3 µg/kg reduced the severity of microemulsion propofol injection pain without increasing arterial blood pressure and heart rate after endotracheal intubation.
Insights
Sufentanil pretreatment, particularly at 0.3 µg/kg, effectively reduced the severity of injection pain from microemulsion propofol. This analgesic approach did not negatively impact vital signs post-intubation.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Propofol is a common anesthetic but can cause adverse reactions.
- Microemulsion propofol reduces some side effects but increases injection pain.
- Investigating methods to mitigate propofol injection pain is crucial.
Purpose of the Study:
- To evaluate the efficacy of preemptive sufentanil analgesia in reducing microemulsion propofol injection pain.
- To compare different doses of sufentanil for pain management.
Main Methods:
- Eighty adult patients (ASA I-II) were randomized into four groups.
- Groups received normal saline or sufentanil (0.1, 0.2, or 0.3 µg/kg) pretreatment.
- Microemulsion propofol was administered, and pain severity was assessed using VAS.
Main Results:
- No significant difference in pain incidence across groups.
- Sufentanil 0.3 µg/kg significantly reduced pain severity compared to saline and 0.1 µg/kg sufentanil.
- Hemodynamic changes and minor adverse events were noted but generally manageable.
Conclusions:
- Pretreatment with 0.3 µg/kg sufentanil effectively decreases the severity of injection pain associated with microemulsion propofol.
- This dose of sufentanil appears safe, without adverse effects on arterial blood pressure or heart rate post-intubation.
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