Esmolol reduces pain on injection of propofol

Abstract Background and objective: This randomized, double-blind, placebo-controlled study was carried out to determine the effect of esmolol on the incidence and severity of pain during propofol injection using a venous retention technique, and to compare it with lidocaine and placebo. Methods: After institutional ethical approval, 150 ASA I-II patients (ages 21–70) undergoing general anaesthesia for elective surgery were randomized to receive esmolol (0.5 mg/kg) (n = 50), lidocaine (0.5 mg/kg) (n = 50) or saline (placebo group, n = 50) diluted into a 5 ml solution after tourniquet application (70 mmHg) on the forearm. The occlusion was released after 30 seconds and 25% of the calculated induction dose of propofol was administrated at the rate of 0.5 ml/s. The patients were observed and asked immediately if they had pain in the arm, and the response was recorded. Results: Twenty-seven patients in the esmolol group, 28 in the lidocaine group, and 8 in the placebo group reported no pain (both groups vs. pl...

[1]  C. Watanabe,et al.  Characteristics of propofol-evoked vascular pain in anaesthetized rats. , 2005, British journal of anaesthesia.

[2]  Y. Chia,et al.  Role of beta-blockade in anaesthesia and postoperative pain management after hysterectomy. , 2004, British journal of anaesthesia.

[3]  Tzou-Yien Lin,et al.  Systemic anaphylaxis following local lidocaine administration during a dental procedure. , 2004, Pediatric emergency care.

[4]  H. Handwerker,et al.  Bradykinin and serotonin effects on various types of cutaneous nerve fibres , 1974, Pflügers Archiv.

[5]  P. White,et al.  The Effect of Intraoperative Use of Esmolol and Nicardipine on Recovery After Ambulatory Surgery , 2003, Anesthesia and analgesia.

[6]  R. Sudha,et al.  Effect of esmolol on oxidant status and antioxidant activity in acute myocardial infarction. , 2003, The Journal of the Association of Physicians of India.

[7]  D. Sessler,et al.  Esmolol prevents movement and attenuates the BIS response to orotracheal intubation. , 2002, British journal of anaesthesia.

[8]  D. Spahn,et al.  Modulation of beta-adrenergic receptor subtype activities in perioperative medicine: mechanisms and sites of action. , 2002, British journal of anaesthesia.

[9]  J. Port,et al.  Altered beta-adrenergic receptor gene regulation and signaling in chronic heart failure. , 2001, Journal of molecular and cellular cardiology.

[10]  J. Chelly,et al.  Antinociceptive and cardiovascular properties of esmolol following formalin injection in rats , 2001, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[11]  M. Tramèr,et al.  Prevention of Pain on Injection with Propofol: A Quantitative Systematic Review , 2000, Anesthesia and analgesia.

[12]  M. Nakane,et al.  A potential mechanism of propofol-induced pain on injection based on studies using nafamostat mesilate. , 1999, British journal of anaesthesia.

[13]  A. Macario,et al.  Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists. , 1999, Anesthesia and analgesia.

[14]  T. Guo,et al.  Role of Pertussis Toxin-sensitive G-Proteins in the Analgesic and Anesthetic Actions of alpha sub 2 -Adrenergic Agonists in the Rat , 1995, Anesthesiology.

[15]  C. Guarnieri,et al.  Influence of the beta-blocker therapy on neutrophil superoxide generation and platelet aggregation in experimental myocardial ischemia and reflow. , 1995, Acta physiologica Hungarica.

[16]  R. Seifert,et al.  Lipophilic beta-adrenoceptor antagonists and local anesthetics are effective direct activators of G-proteins. , 1994, Biochemical pharmacology.

[17]  T. Fuhrman,et al.  Comparison of the efficacy of esmolol and alfentanil to attenuate the hemodynamic responses to emergence and extubation. , 1992, Journal of clinical anesthesia.

[18]  D. Mangar,et al.  Tourniquet at 50 mm Hg Followed by Intravenous Lidocaine Diminishes Hand Pain Associated With Propofol Injection , 1992, Anesthesia and analgesia.

[19]  R. Martineau,et al.  Bolus administration of esmolol for controlling the haemodynamic response to tracheal intubation: the canadian multicentre trial , 1991, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[20]  J. Arndt,et al.  Pain evoked by polymodal stimulation of hand veins in humans. , 1991, The Journal of physiology.

[21]  E. Röth Effect of Ca-antagonists, beta-blockers and antioxidant during reperfusion period. , 1991, Bratislavske lekarske listy.

[22]  A. Mccrirrick,et al.  Pain on injection of propofol: the effect of injectate temperature , 1990, Anaesthesia.

[23]  C. Skillman,et al.  Use of Esmolol During Anesthesia to Treat Tachycardia and Hypertension , 1989, Anesthesia and analgesia.

[24]  V. Murthy,et al.  Cardiovascular and Neuromuscular Effects of Esmolol During Induction of Anesthesia , 1986, Journal of clinical pharmacology.

[25]  R. Gorczynski Basic pharmacology of esmolol. , 1985, The American journal of cardiology.

[26]  T. Nikkari,et al.  Exercise‐Induced Increase in Plasma Arachidonic Acid and Thromboxane B2 in Healthy Men: Effect of β-Adrenergic Blockade , 1984, Journal of cardiovascular pharmacology.

[27]  T. Ban,et al.  Frequency-dependent block of nerve conduction by beta-adrenergic blocking agents. , 1981, Archives internationales de pharmacodynamie et de therapie.

[28]  M. Sasa,et al.  Local anesthetic activity of beta-adrenergic blocking drugs in the Crayfish giant axon, with reference to calcium ion. , 1980, Japanese journal of pharmacology.