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Abstract
Pain on intravenous injection of propofol remains a problem and disadvantage of its use. Many strategies and techniques had been tried and applied in order to reduce or abolish this pain. Lidocaine pretreatment with a tourniquet was found the most effective method. In spite of this strategy of treatment there is still a proportion of patients suffering pain on propofol injection. So the use of other drugs has been suggested.
The aim of this study was to compare and evaluate the use of different doses of ondansetron and granisetron for reduction of pain on intravenous injection of propofol during induction of general anaesthesia. This study was carried out on 150 adult ASA or female patients. The patients were scheduled for elective simple day-case surgeries (likely to last around 15 minutes) under general anaesthesia without endotracheal intubation.
Patients were randomly assigned into five equal groups, thirty patients each:
• Group (group L) control group: Patients received 2 % lidocaine solution IV dose of 0.5 mg/kg body weight.
• Group (group O4) : Patients received 4 mg ondansetron IV.
• Group (group O8) : Patients received 8 mg ondansetron IV.
• Group V (group G1) : Patients received 1 mg granisetron IV.
• Group V (group G2) : Patients received 2 mg granisetron IV.
A venous occlusion strain gauge was applied to the forearm for venous occlusion with a standard pressure between 50 mmHg and 70 mmHg. An intravenous cannula in the dorsum of the left hand was secured. No other drugs or continuous fluids were administered prior to or after propofol and the study drugs injection. The study drugs were prepared as 5 ml of colourless solution and administered over 3 seconds 60 seconds prior to propofol injection and patients were asked whether they feel any pain during administration of the pre-treatment solution. During 10 seconds pause after giving 50 mg of 1 % propofol at room temperature. The degree of pain experienced by the patients during injection of propofol and study drugs was scored by the verbal rating scale which was described by McCrirrick A et al (35).
The following data were recorded for the patients in all groups:
• Demographic data (age, body weight).
• Scoring of pain intensity after injection of the study drugs.
• Scoring of pain intensity after injection of propofol.
• Recall of pain at the end of anaesthesia.
• Any incidence of post-operative nausea and vomiting was recorded during the 1st six hours after the surgery.
• Any incidence of pain, edema, reddness, erythema or allergic reaction at the injection site was recorded during the 1st six hours after the surgery.
• Any incidence of side effects of the study drugs such as headache, dizziness, constipation, arrhythmia and transient blurred of vision was recorded during the 1st six hours after the surgery.