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Published in: BMC Anesthesiology 1/2017

Open Access 01-12-2017 | Research article

Is propofol injection pain really important to patients?

Authors: Wen Wang, Linxin Wu, Chaobin Zhang, Li Sun

Published in: BMC Anesthesiology | Issue 1/2017

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Abstract

Background

Propofol injection pain (PIP) has been adequately studied during the past decades. However, patients’ opinion on this problem and the incidence of patients’ recall of this brief discomfort are still unknown. Thus, we conducted this study to know the patients’ perspectives on PIP and provide useful information about the incidence of recall of PIP under our routine general anesthesia.

Methods

Five hundred preoperative questionnaires were distributed to patients who were scheduled for elective open thyroidectomy under general anesthesia from May 2016 to July 2016. They were asked to rank ten possible adverse effects associated with general anesthesia from their most undesirable to their least undesirable effect. Patients who completed the preoperative questionnaires were asked whether they could recall PIP and to grade the severity of PIP on the first postoperative day.

Results

A total of 448 preoperative questionnaires were returned and analyzed with an efficient rate of 89.6%. Incisional pain was ranked as most undesirable, followed (in order) by vomiting, gagging on the tracheal tube, nausea, sore throat, propofol injection pain, shivering, intravenous puncture pain, and anxiety. The majority (91.5%) of surveyed patients could not recall any discomfort or pain during anesthetics injection. Of those who could recall PIP, 89.5% grade it as mild pain, 7.9% moderate pain, and 2.6% severe pain.

Conclusions

Most of patients undergoing elective open thyroidectomy in our hospital viewed PIP as a relatively minor problem. The incidence of recall of PIP was low and the majority of those who recalled regarded it as mild, temporary and acceptable pain. However, further investigations into propofol injection pain may be warranted as patients’ perspectives on propofol injection pain and its severity may differ between patient populations.
Literature
1.
go back to reference Boelle PY, Garnerin P, Sicard JF, Clergue F, Bonnet F. Voluntary reporting system in anaesthesia: is there a link between undesirable and critical events? Qual Health Care. 2000;9:203–9.CrossRefPubMedPubMedCentral Boelle PY, Garnerin P, Sicard JF, Clergue F, Bonnet F. Voluntary reporting system in anaesthesia: is there a link between undesirable and critical events? Qual Health Care. 2000;9:203–9.CrossRefPubMedPubMedCentral
2.
go back to reference Macario A, Weinger M, Truong P, Lee M. Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists. Anesth Analg. 1999;88:1085–91.CrossRefPubMed Macario A, Weinger M, Truong P, Lee M. Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists. Anesth Analg. 1999;88:1085–91.CrossRefPubMed
3.
go back to reference Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg. 1999;89:652–8.PubMed Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg. 1999;89:652–8.PubMed
4.
go back to reference Jenkins K, Grady D, Wong J, Correa R, Armanious S, Chung F. Post-operative recovery: day surgery patients’ preferences. Br J Anaesth. 2001;86:272–4.CrossRefPubMed Jenkins K, Grady D, Wong J, Correa R, Armanious S, Chung F. Post-operative recovery: day surgery patients’ preferences. Br J Anaesth. 2001;86:272–4.CrossRefPubMed
5.
go back to reference Wagner DS, Yap JM, Bradley KM, Voepel-Lewis T. Assessing parents preferences for the avoidance of undesirable anesthesia side effects in their children undergoing surgical procedures. Paediatr Anaesth. 2007;17:1035–42.PubMed Wagner DS, Yap JM, Bradley KM, Voepel-Lewis T. Assessing parents preferences for the avoidance of undesirable anesthesia side effects in their children undergoing surgical procedures. Paediatr Anaesth. 2007;17:1035–42.PubMed
6.
go back to reference Rashiq S, Bray P. Relative value to surgical patients and anesthesia providers of selected anesthesia related outcomes. BMC Med Inform Decis Mak. 2003;3:3.CrossRefPubMedPubMedCentral Rashiq S, Bray P. Relative value to surgical patients and anesthesia providers of selected anesthesia related outcomes. BMC Med Inform Decis Mak. 2003;3:3.CrossRefPubMedPubMedCentral
7.
go back to reference Carvalho B, Cohen SE, Lipman SS, Fuller A, Mathusamy AD, Macario A. Patient preferences for anesthesia outcomes associated with cesarean delivery. Anesth Analg. 2005;101:1182–7. table of contents.CrossRefPubMed Carvalho B, Cohen SE, Lipman SS, Fuller A, Mathusamy AD, Macario A. Patient preferences for anesthesia outcomes associated with cesarean delivery. Anesth Analg. 2005;101:1182–7. table of contents.CrossRefPubMed
8.
go back to reference Moro ET, Godoy RC, Goulart AP, Muniz L, Modolo NS. Main concerns of patients regarding the most common complications in the post-anesthetic care unit. Rev Bras Anestesiol. 2009;59:716–24.PubMed Moro ET, Godoy RC, Goulart AP, Muniz L, Modolo NS. Main concerns of patients regarding the most common complications in the post-anesthetic care unit. Rev Bras Anestesiol. 2009;59:716–24.PubMed
9.
go back to reference Jalota L, Kalira V, George E, Shi YY, Hornuss C, Radke O, Pace NL, Apfel CC, Perioperative Clinical Research Core. Prevention of pain on injection of propofol: systematic review and meta-analysis. BMJ. 2011;342:d1110.CrossRefPubMed Jalota L, Kalira V, George E, Shi YY, Hornuss C, Radke O, Pace NL, Apfel CC, Perioperative Clinical Research Core. Prevention of pain on injection of propofol: systematic review and meta-analysis. BMJ. 2011;342:d1110.CrossRefPubMed
10.
11.
go back to reference Veselis RA, Reinsel RA, Feshchenko VA, Dnistrian AM. A neuroanatomical construct for the amnesic effects of propofol. Anesthesiology. 2002;97:329–37.CrossRefPubMed Veselis RA, Reinsel RA, Feshchenko VA, Dnistrian AM. A neuroanatomical construct for the amnesic effects of propofol. Anesthesiology. 2002;97:329–37.CrossRefPubMed
12.
go back to reference Ren Y, Wang J, Xu PB, Xu YJ, Miao CH. Systemic or intra-amygdala infusion of an endocannabinoid cb1 receptor antagonist am251 blocked propofol-induced anterograde amnesia. Neurosci Lett. 2015;584:287–91.CrossRefPubMed Ren Y, Wang J, Xu PB, Xu YJ, Miao CH. Systemic or intra-amygdala infusion of an endocannabinoid cb1 receptor antagonist am251 blocked propofol-induced anterograde amnesia. Neurosci Lett. 2015;584:287–91.CrossRefPubMed
13.
go back to reference Nyhus E, Curran T. Midazolam-induced amnesia reduces memory for details and affects the erp correlates of recollection and familiarity. J Cogn Neurosci. 2012;24:416–27.CrossRefPubMed Nyhus E, Curran T. Midazolam-induced amnesia reduces memory for details and affects the erp correlates of recollection and familiarity. J Cogn Neurosci. 2012;24:416–27.CrossRefPubMed
14.
go back to reference Matsuki Y, Ichinohe T, Kaneko Y. Amnesia for electric dental pulp stimulation and picture recall test under different levels of propofol or midazolam sedation. Acta Anaesthesiol Scand. 2007;51:16–21.CrossRefPubMed Matsuki Y, Ichinohe T, Kaneko Y. Amnesia for electric dental pulp stimulation and picture recall test under different levels of propofol or midazolam sedation. Acta Anaesthesiol Scand. 2007;51:16–21.CrossRefPubMed
15.
go back to reference Kim K, Sung Kim Y, Lee DK, Lim BG, Kim HZ, Kong MH, Kim NS, Lee IO. Reducing the pain of microemulsion propofol injections: a double-blind, randomized study of three methods of tourniquet and lidocaine. Clin Ther. 2013;35:1734–43.CrossRefPubMed Kim K, Sung Kim Y, Lee DK, Lim BG, Kim HZ, Kong MH, Kim NS, Lee IO. Reducing the pain of microemulsion propofol injections: a double-blind, randomized study of three methods of tourniquet and lidocaine. Clin Ther. 2013;35:1734–43.CrossRefPubMed
16.
go back to reference Wallentine CB, Shimode N, Egan TD, Pace NL. Propofol in a modified cyclodextrin formulation: first human study of dose–response with emphasis on injection pain. Anesth Analg. 2011;113:738–41.CrossRefPubMed Wallentine CB, Shimode N, Egan TD, Pace NL. Propofol in a modified cyclodextrin formulation: first human study of dose–response with emphasis on injection pain. Anesth Analg. 2011;113:738–41.CrossRefPubMed
17.
go back to reference Aldrete JA, Otero P, Alcover J, Parietti A, Johnson SC, Montpetit FH, Torrieri A, Quiroga D. Pain on injection from propofol may be avoided by changing its formulation. Acta Anaesthesiol Scand. 2010;54:442–6.CrossRefPubMed Aldrete JA, Otero P, Alcover J, Parietti A, Johnson SC, Montpetit FH, Torrieri A, Quiroga D. Pain on injection from propofol may be avoided by changing its formulation. Acta Anaesthesiol Scand. 2010;54:442–6.CrossRefPubMed
18.
go back to reference Soltesz S, Diekmann M, Mitrenga-Theusinger A, Keilen M, Molter GP. Reduced pain on injection with a 0.5% propofol emulsion during induction of anesthesia. Eur J Anaesthesiol. 2012;29:162–3.CrossRefPubMed Soltesz S, Diekmann M, Mitrenga-Theusinger A, Keilen M, Molter GP. Reduced pain on injection with a 0.5% propofol emulsion during induction of anesthesia. Eur J Anaesthesiol. 2012;29:162–3.CrossRefPubMed
19.
go back to reference Shimizu T, Inomata S, Tanaka M. Rapid injection of propofol reduces vascular pain and facilitates laryngeal mask airway insertion. J Clin Anesth. 2011;23:540–3.CrossRefPubMed Shimizu T, Inomata S, Tanaka M. Rapid injection of propofol reduces vascular pain and facilitates laryngeal mask airway insertion. J Clin Anesth. 2011;23:540–3.CrossRefPubMed
20.
go back to reference Brock MF, Grace BE, Morley B, Hillegass G, Houle TT, Groban L. Does lidocaine more effectively prevent pain upon induction with propofol or etomidate when given preemptively than when mixed with the drug? J Clin Anesth. 2010;22:505–9.CrossRefPubMed Brock MF, Grace BE, Morley B, Hillegass G, Houle TT, Groban L. Does lidocaine more effectively prevent pain upon induction with propofol or etomidate when given preemptively than when mixed with the drug? J Clin Anesth. 2010;22:505–9.CrossRefPubMed
21.
go back to reference Borazan H, Erdem TB, Kececioglu M, Otelcioglu S. Prevention of pain on injection of propofol: a comparison of lidocaine with different doses of paracetamol. Eur J Anaesthesiol. 2010;27:253–7.CrossRefPubMed Borazan H, Erdem TB, Kececioglu M, Otelcioglu S. Prevention of pain on injection of propofol: a comparison of lidocaine with different doses of paracetamol. Eur J Anaesthesiol. 2010;27:253–7.CrossRefPubMed
22.
go back to reference Honarmand A, Safavi M. Prevention of propofol-induced injection pain by sufentanil: a placebo-controlled comparison with remifentanil. Clin Drug Investig. 2008;28:27–35.CrossRefPubMed Honarmand A, Safavi M. Prevention of propofol-induced injection pain by sufentanil: a placebo-controlled comparison with remifentanil. Clin Drug Investig. 2008;28:27–35.CrossRefPubMed
23.
go back to reference Basaranoglu G, Erden V, Delatioglu H. Reduction of pain on injection of propofol: a comparison of fentanyl with remifentanil. Anesth Analg. 2002;94:1040–1.CrossRefPubMed Basaranoglu G, Erden V, Delatioglu H. Reduction of pain on injection of propofol: a comparison of fentanyl with remifentanil. Anesth Analg. 2002;94:1040–1.CrossRefPubMed
24.
go back to reference Tversky A, Kahneman D. Judgment under uncertainty: heuristics and biases. Science. 1974;185:1124–31.CrossRefPubMed Tversky A, Kahneman D. Judgment under uncertainty: heuristics and biases. Science. 1974;185:1124–31.CrossRefPubMed
Metadata
Title
Is propofol injection pain really important to patients?
Authors
Wen Wang
Linxin Wu
Chaobin Zhang
Li Sun
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2017
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-017-0321-7

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