Vol 44 # 2 June 2012 - Kma.org.kw

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KUWAIT MEDICAL JOURNAL
June 2012
Original Article
Determining the Effect of Sufentanil
on Propofol Injection Pain
Tuba Berra Saritas, Hale Borazan, Inci Kara, Sema Tuncer, Seref Otelcioglu
Department of Anesthesiology and Reanimation, Selcuk University Meram Medical School, Konya, Turkey
Kuwait Medical Journal 2012; 44 (2): 121 - 124
ABSTRACT
Objectives: Propofol is a general anesthetic. Its most
important disadvantage is pain on injection. Our aim was
to evaluate the effectiveness of sufentanil on propofol
injection pain (PIP).
Design: Case control randomized double-blind study
Setting: Anesthesia department of Selcuk University
Meram Medical School , Turkey
Subjects: A total of 160 adults, 18 to 65 years, ASA I-II
patients, scheduled for operations under general anesthesia,
were enrolled in this study. A 22-gauge intravenous (IV)
catheter was inserted into a vein on the dorsum of the
hand. Patients were randomly allocated to one of four
groups to receive either saline or 0.5, 1, 2 mcg sufentanil
in 2 ml volume. Thirty seconds after the intravenous (IV)
injection of the pretreatment drug, 5 ml of 1% propofol at
room temperature (Fresenius Kabi, Hamburg, Germany)
was injected IV at rate of 0.5 ml/sec. Pain was assesed
verbally and scored as none (0), mild (1), moderate (2),
severe (3).
Interventions: Prior injection of sufentanil or placebo
Main Outcome Measures: Severity of PIP
Results: Demographic data were comparable among
four groups. Sufentanil at 1 and 2 mcg doses significantly
decreased pain incidence when compared to the saline
group (p < 0.05). Sufentanil 0.5 mcg had no effect (p >
0.05). Although 2 mcg sufentanil decreased the incidence
of PIP more than 1 mcg, there was no significant difference
between these groups (p > 0.05).
Conclusion: Sufentanil at one and 2 mcg doses reduced
the incidence and severity of PIP
KEY WORDS: general anesthesia, pain, propofol, sufentanil
INTRODUCTION
Propofol is a frequently used intravenous (IV)
anesthetic for induction of anesthesia and for sedation
in daycase surgery. The most important disadvantage
of propofol is injection pain, which is reported in 28
- 90% of patients [1] .
Many different methods have been proposed to
reduce the incidence and severity of this adverse
effect of propofol. Pretreatment with alfentanil [2] , use
of fentanyl [3] , local anesthetics [4] , metoclopramide [5] ,
tramadol [6] , ketamine [7] , ondansetron [8] , addition of
lidocaine [9,10] , alfentanil [11] ephedrine [12] , granisetron [13] ,
and injection of propofol into a large antecubital vein
or into a freely flowing intravenous (IV) line, are
the techniques described for prevention of propofol
injection pain (PIP) .
Fentanyl, remifentanil, alfentanil and sufentanil
can provide analgesia and assist anesthetic effects
when used as presurgical medication, induction or
maintenance agents, for postsurgical pain relief and
neurolept and neuroleptanalgesia and as supplements
to regional anesthesia. Opioids are also reported to
be effective in preventing PIP [3,10,11] . Sufentanil is a
selective μ receptor agonist, 5-10 times more effective
analgesic than fentanyl and with a high safety [14] .
However, there are few studies in literature that
report sufentanil analgesic effect on PIP. In this study
we tried to evaluate effectiveness of sufentanil, in
prevention of PIP.
SUBJECTS AND METHODS
Ethics Committee approval was obtained from
Selcuk University Meram Medical Faculty. All
patients gave their informed and written consent.
A total of 160 adult, aged between 18 to 65 years,
ASA physical status I-II patients, scheduled for
operations under general anesthesia, were enrolled
into this randomized, double-blind study conducted
in 2006 at the anesthesiology department of Meram
Medical School of Selcuk University. Patients with
Address correspondence to:
Tuba Berra Saritas, MD, Associate Professor, Selcuk University Meram Medical School, Department of Anesthesiology and Reanimation,
Konya,Turkey. Tel: 90 3322236166, Fax: 90 3322236181, E-mail:erdemtugba@hotmail.com