Effectiveness of veno-occlusion with lignocaine for prevention of propofolinduced vascular pain at the Kenyatta National Hospital.

Abstract

Background Propofol is an intravenous sedative hypnotic agent widely used for induction and maintenance of general anesthesia. Pain is an acknowledged reaction of propofol administration which can be very disquieting to the patient [1–3]. Identifying an ideal method to lower the pain levels precipitated by propofol on induction has been a challenge and thus several studies have been conducted in view of the same, one being the use of lignocaine with venous occlusion [4]. Study Objective To compare the two methods used to reduce propofol-induced pain; one involving venoocclusion with lignocaine and one using lignocaine without veno-occlusion during Propofol injection. Study Design This was a comparative observational study carried out at the KNH main theatre during induction of anesthesia. 78 adult patients aged between 18-85 years were included in this study. The study procedure was explained to eligible patients and a written informed consent obtained. The anesthetic choice and application was at the discretion of the attending anesthesiologist to whom information was made known that observation would be made using VAS scores on tolerability to pain with propofol administration. Results lidocaine is widely used for alleviating PVP and our findings showed that giving 40mg of 2% lidocaine for 60seconds with venous occlusion [4–6] has proven to be more superior and effective than giving lidocaine alone prior to propofol administration with no major correlation on age, gender or ASA status. This is confirmed from the lower mean pain scores in the veno occlusion group compared to the lidocaine alone group. (U=110, P= <0.001) Conclusion It is apparent that the strategy to preclude PVP should be multifaceted and that giving 40mg of 2% lidocaine for 60seconds with venous occlusion [4–6] has proven to be more superior and effective than giving lidocaine alone prior to propofol administration.