Related Experiment Video
Updated: Sep 19, 2025

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
Skin cooling and topical application of menthol can reduce propofol injection-induced pain, a randomized trial
Takashi Ishida1, Natsuko Watanabe, Satoshi Tanaka
1Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto City, Nagano, Japan.
Background:
Skin cooling has an analgesic effect on propofol injection-induced pain. We evaluated the analgesic effectiveness of topical menthol application and skin cooling for reducing propofol injection-induced pain.
Methods:
Patients (n = 120) were randomized to a cooling group, a room temperature group (non-cooling group), a menthol group, and a solvent group. In the cooling group, a cooling gel pad (7°C) was applied to the forearm. In the non-cooling group, a gel pad (25°C) was used. In the menthol group, 30% menthol was applied to the forearm. In the solvent group, a solvent was applied. Fifteen minutes after these interventions, propofol was intravenously injected. We assessed the incidence and severity of propofol injection-induced pain.
Results:
The incidence of propofol injection-induced pain in the cooling group was significantly lower than that in the non-cooling group (27% vs 52%, P = .049). The pain intensity in the cooling group was lower than that in the non-cooling group (P = .027). The incidence of propofol injection-induced pain in the menthol group was significantly lower than that in the solvent group (13% vs 40%, P = .020). The pain intensity in the menthol group was lower than that in the solvent group (P = .021).
Conclusion:
Topical menthol application and skin cooling are effective for reducing propofol injection-induced pain.
Related Concept Videos
Parenteral Anesthetics: Overview
Local Anesthetics: Common Agents and Their Applications
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
Inhalational Anesthetics: Overview
Decreased Body Temperature
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

