Korean J Anesthesiol.  2014 Feb;66(2):99-104. 10.4097/kjae.2014.66.2.99.

Analgesic effects of palonosetron in the intravenous propofol injection

• Ryu HB
• Kim SJ

• KMID: 2092428
• DOI: http://doi.org/10.4097/kjae.2014.66.2.99

Abstract

BACKGROUND
Propofol is a good induction agent, but it has the disadvantage of causing pain on intravenous injection. The incidence of propofol-induced pain is approximately 70%. Palonosetron is a novel second-generation 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist. We presumed that palonosetron would be effective in reducing the occurrence of propofol-induced pain based on similar mechanisms to other 5-HT3 receptor antagonists.
METHODS
Eighty patients were randomized to either Group N (0.9% sodium chloride [normal saline] 2 ml, n = 40) or Group P (palonosetron 0.075 mg, 2 ml, n = 40). Patients were intravenously given a 2 ml pretreatment solution, containing either palonosetron 0.075 mg or normal saline. Following pretreatment with 2 ml of palonosetron 0.075 mg or normal saline, we manually occluded venous drainage midarm with the help of an assistant. One minute later, we released the occlusion of venous drainage. This was followed by a 5-second propofol injection at 25% of the total calculated doses. Patients were then interviewed about whether or not they experienced propofol-induced pain.
RESULTS
Overall, the incidence of propofol-induced pain was 60% in the normal saline group and 27.5% in the palonosetron group. No patients in the palonosetron group experienced severe pain. The incidence of propofol-induced pain was significantly lower in the palonosetron group compared to the normal saline group (P < 0.01).
CONCLUSIONS
Following pretreatment with palonosetron, 72.5% of patients experienced a decrease in the occurrence of propofol-induced pain.

Keyword

Injections; Pain; Palonosetron; Propofol

MeSH Terms

Drainage
Humans
Incidence
Injections, Intravenous
Propofol*
Receptors, Serotonin, 5-HT3
Serotonin
Sodium Chloride
Propofol
Receptors, Serotonin, 5-HT3
Serotonin
Sodium Chloride