Pain with propofol injection occurs in majority of patients. Propofol injection pain can be reduced by the following methods explained here.
Propofol causes pain or discomfort on injection in 28% to 90% of awake patients. A number of techniques have been tried for minimizing propofol injection pain with variable results.
The propofol injection pain decreases when the drug is injected into a large vein rather than a dorsum vein on the hand.
The most frequently used method to reduce this pain is premixture with 1% lidocaine (20—40 mg). Prior administration of a potent short-acting opioid (Alfentanil 1 mg, pretreatment with ketamine (100 microg/kg,889 small dose of ephedrine (30—70 microg/kg, also decreases the incidence of pain.
Various other drugs such as butorphanol, metoclopramide, flurbiprofen axetil, ondansetron, ketorolac are also tried. Recently, a modified lipid emulsion of propofol containing medium-chain triglycerides (MCT) with long-chain triglycerides (LCT), in contrast to the usual LCT formulation, has been advocated to alleviate pain.
The reason for less Pain with propofol injection with LCT/MCT propofol may be attributed to a decreased concentration of propofol in the aqueous phase.
Accidental intra-arterial injection produces hyperaemia around the injection site along with propofol injection pain at injection site. A temporary blanching appear distal to the injection site.95’96 Intra-arterial propofol is not directly toxic to vascular endothelium