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Reduction of pain during induction with target-controlled propofol and remifentanil
Cited 31 time in
Web of Science
Cited 33 time in Scopus
- Authors
- Issue Date
- 2007-11-17
- Publisher
- Oxford University Press
- Citation
- Br J Anaesth. 2007 Dec;99(6):876-80.
- Keywords
- Adolescent ; Adult ; Aged ; Analgesics, Opioid/adverse effects/*therapeutic use ; Anesthetics, Intravenous/administration & dosage/*adverse effects ; Double-Blind Method ; Drug Delivery Systems ; Female ; Humans ; Infusions, Intravenous/adverse effects ; Male ; Middle Aged ; Pain/etiology/*prevention & control ; Pain Measurement/methods ; Piperidines/adverse effects/*therapeutic use ; Propofol/administration & dosage/*adverse effects ; Prospective Studies
- Abstract
- BACKGROUND: Pain on injection of propofol is unpleasant. We hypothesized that propofol infusion pain might be prevented by infusing remifentanil before starting the propofol infusion in a clinical setting where target-controlled infusions (TCI) of both drugs were used. A prospective, randomized, double-blind, placebo-controlled trial was performed to determine the effect-site concentration (Ce) of remifentanil to prevent the pain without producing complications. METHODS: A total of 128 patients undergoing general surgery were randomly allocated to receive normal saline (control) or remifentanil to a target Ce of 2 ng ml(-1) (R2), 4 ng ml(-1) (R4), or 6 ng ml(-1) (R6) administered via TCI. After the target Ce was achieved, the infusion of propofol was started. Remifentanil-related complications were assessed during the remifentanil infusion, and pain caused by propofol was evaluated using a four-point scale during the propofol infusion. RESULTS: The incidence of pain was significantly lower in Groups R4 and R6 than in the control and R2 groups (12/32 and 6/31 vs 26/31 and 25/32, respectively, P<0.001). Pain was less severe in Groups R4 and R6 than in the control and R2 groups (P<0.001). However, both incidence and severity of pain were not different between Groups R4 and R6. No significant complications were observed during the study. CONCLUSIONS: During induction of anaesthesia with TCI of propofol and remifentanil, a significant reduction in propofol infusion pain was achieved without significant complications by prior administration of remifentanil at a target Ce of 4 ng ml(-1).
- ISSN
- 1471-6771 (Electronic)
- Language
- English
- URI
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18006530
https://hdl.handle.net/10371/24697
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