Comparison of the Effects of Ketorolac, Metoclopramide, Lidocaine on Reducing Pain During Propofol IV Injection in general anesthesia induction

Comparison of the Effects of Ketorolac, Metoclopramide, Lidocaine on Reducing Pain During Propofol IV Injection

randomized double blinded clinical trial with control and parallel groups

In this study 120 patients are randomly devided into four groups. Before anesthesia induction, 2 cc water is injected to group A, 40 mg Lidocaine is injected to group L, 10 mg Metoclopramide is injected to group M and 30 mg Ketorolac is injected to group K intravenously; which is followed by IV injection of 30 mg propofol at rate of 0.5 cc per min to all four groups. Immediately after propofol injection and before complete anesthesia, pain severity is recorded by operating room technician according to verbal rating score (VRS) as following: without pain (0), mild: the pain which is expressed verbally with no grimacing (1), moderate: the pain which is expressed by grimacing (2), severe: the pain which is accompanied by screaming or arm withdrawal (3) Then the rest of Propofol is injected.

Inclusion criteria: Patients between 18-50 years old who candidates for elective operation . Exclusion criteria: any history of sedative, narcotic or analgesic agent use during 24 hours before surgery, any history of narcotic or analgesic drug or alcohol abuse, any contraindication of Propofol, Lidocain, Ketorolac or other NSAIDs use, chronic pain syndromes, past history of neurologic or psychiatric disorders, pregnancy, inability to communicate verbally.

Group A: IV injection of Propofol after water Group L: IV injection of Propofol after Lidocaine Group M:IV injection of Propofol after Metoclopramide Group K: IV injection of Propofol after Ketorolac

pain severity, intervention, age, sex, BMI, ASA, comorbidities, smoking

We use classified quadratic permutation block to randomize the patients. All the patients are divided into 4 groups including men 18to34 years old, women 18to34 years old, men 35to50 years old and women 35to50 years old. Then blocked randomization is applied to each group separately.

Blinding is applied to both patients and anesthesiologist who injects drugs and records the pain severity.The anesthesiologist is unaware of the type of the drugs and injects prefilled syringes; then he asks about the severity of pain and records the answers. The patient are unaware of the type of the drug ,too.