Efficacy of different fluids preload on propofol injection pain: A randomized, controlled, double-blinded study

Area of Science:

• Anesthesiology
• Pharmacology
• Clinical Medicine

Background:

• Propofol injection pain is a frequent clinical issue.
• Previous research suggested topical nitroglycerin can reduce propofol pain.
• This study investigated fluid preload as a method to mitigate propofol injection pain.

Purpose of the Study:

• To evaluate the efficacy of different types and volumes of fluid preload in reducing propofol injection pain.
• To compare the pain-reducing effects of Plasma-Lyte A, 0.9% saline, and Gelofusine as preloads.
• To determine the optimal fluid preload strategy for minimizing propofol injection discomfort.

Main Methods:

• 200 adult patients were randomized into five groups receiving different fluid preloads (Plasma-Lyte A 100 mL, 250 mL, 500 mL; 0.9% saline 500 mL; Gelofusine 500 mL).
• Propofol (0.5 mg/kg, 1%) was injected post-preload at a standardized rate.
• Pain incidence and intensity were assessed by a blinded investigator using a four-point scale.

Main Results:

• The incidence of propofol injection pain decreased with increasing volumes of Plasma-Lyte A (P100: 87.5%, P250: 57.5%, P500: 35%).
• The 500 mL Plasma-Lyte A (P500) and Gelofusine (G500) groups showed significantly lower pain incidence and intensity compared to other groups, including the 500 mL saline group (N500).
• No significant difference in pain reduction was observed between Plasma-Lyte A 500 mL and Gelofusine 500 mL preloads.

Conclusions:

• Administering a 500 mL preload of Plasma-Lyte A or Gelofusine is effective in alleviating propofol-induced injection pain.
• Fluid preload, particularly with Plasma-Lyte A or Gelofusine, offers a viable strategy to manage propofol injection discomfort.
• The choice of fluid preload solution and volume significantly impacts the incidence and intensity of propofol injection pain.