Prevention of Pain on Propofol Injection: A Comparison of Pretreatment with 5-Hydroxytryptamine 3 Antagonists Granisetron, Ondansetron, and Ramosetron.
Srishti Kindo, Nitesh Sinha, Dipali Singh et al.
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In 30 seconds
This randomized controlled trial compared pretreatment with three 5-hydroxytryptamine 3 receptor antagonists for preventing propofol injection pain in 120 adults undergoing elective laparoscopic cholecystectomy. Participants received granisetron, ramosetron, ondansetron, or saline, with pain assessed over 20 seconds. All three active drugs reduced pain compared with saline; granisetron had the lowest reported incidence of pain: 26.7%, versus 70% with ramosetron, 80% with ondansetron, and 100% with saline (P < 0.001).
Key findings
- Propofol injection pain occurred in 26.7% of patients given granisetron, compared with 70% with ramosetron, 80% with ondansetron, and 100% with saline (χ² =40.443, P < 0.001).
- Granisetron produced a mean verbal rating scale score of 0.00 at 20 s.
- Pain was significantly lower with each of the three antagonists than with saline at all assessment times (P < 0.001).
Why it matters
Pain during propofol injection is common, and this trial suggests that pretreatment with these 5-hydroxytryptamine 3 receptor antagonists can reduce its incidence and severity. The marked difference reported for granisetron may inform consideration of options for reducing injection discomfort, while the findings apply to the studied perioperative setting and protocol.
What to keep in mind
The trial included 120 adults undergoing one type of elective surgery, and pain was assessed only through 20 s after injection.