Influence of Temperature and pH Changes on …

1 Turk J Anaesth Reanim 2013; 41: 34-7 Influence of Temperature and pH Changes on propofol injection PainPropofol n S cakl k ve pH De i iminin Enjeksiyon A r s zerine EtkisiAma : propofol , %60-70 oran nda enjeksiyon a r s na neden olmas na ra men anestezide yayg n kullan l r. Bu al mada buzdolab nda ve ameli-yathane odas nda saklanan propofol ampullerinin enjeksiyon a r s iddeti ve s kl zerine etkisini saptamay ama lad ntemler: Genel anestezi alt nda gastrointestinal ve rolojik cerrahi ge- irecek 200 hasta bu prospektif,randomize, ift k r al maya dahil edildi.

2 Rutin monit rizasyonun ard ndan oda s s ndaki 5 mL propofol (Grup 1) ve buzdolab ndaki 5 mL propofol (Grup 2) 10 sn i inde enjekte edildi. Bir ara t rmac a r y di er bir ara t rmac ise propofol n s cakl k ve pH s n de : propofol enjeksiyon a r s n n genel insidans Grup 1 de %73,7, Grup 2 de %83,2 idi ve istatistiksel olarak anlaml bulunmad .Verbal Ra-ting Skala kullan larak de erlendirilen a r iddeti a s ndan ise gruplar aras nda anlaml fark saptand . Ortalama VRS de eri Grup 1 de 2, Grup 2 de 3 bulundu.

3 Sonu : So uk uygulama lokal anestetik etkiye sahiptir. Sunulan al mada istatistiksel olarak anlaml olmasa da so uk propofol n daha fazla hastada a r ya neden oldu u; istatistiksel olarak anlaml ekilde ise daha iddetli a r ya neden oldu u bulundu. Bu bulgular nda propofol n buzdolab yerine oda s s nda saklanmas n n enjeksiyon a r s n azaltaca n d Kelimeler: propofol , enjeksiyon, a r , pHObjective: propofol has been widely used for anaesthesiology, although about 60%-70% of patients experience pain on injection .

4 The aim of our study was to compare two storage patterns of propofol , namely room Temperature versus refrigeration, in terms of their effect on incidence and severity of pain caused by its : Two hundred patients referred to gastrointestinal or urologic surgery with general anaesthesiology were included in a prospective rand-omized, double-blind study. After routine monitoring, 5 mL of propofol at room Temperature and 5 mL of propofol kept in the fridge was adminis-tered within 10 seconds to patients in Group 1 and Group 2, respectively.

5 An investigator assessed pain intensity. propofol Temperature -pH were measured by another researcher. Results: The overall incidence of pain on injection of propofol was in Group 1, and in Group 2. There was no significant difference between groups regarding the incidence of pain . There was a significant difference between groups in terms of pain severity based on a 6-point verbal rating scale. While the median VRS value for Group 1 was 2, it was 3 in Group 2. Conclusion: Cold application has a local anesthetic effect of its own.

6 In the present study it was observed that cold application of propofol caused pain more frequently, although it was statistically not significant; moreo-ver, it was found that it statistically significantly increased the severity of pain . These findings indicate that propofol should be kept at room tem-perature instead of in the refrigerator in order to reduce injection pain . Key Words: propofol , injection , pain , pHIntroductionBeing an intravenous short-acting anaesthetic agent, propofol has been widely used for sedation and anaesthesiology.

7 It not only produces smooth and rapid induction and recovery, but has an antiemetic effect as well, making propofol preferable for day care anaesthesiology. However, despite these positive effects, about 60%-70% of patients experience pain on injection of propofol (1). To prevent propofol injection pain , several studies have been performed using pharmacologic and non-pharmacologic methods, such as selecting an antecubital vein or a hand vein, slower or faster injection rates, using different temperatures of propofol (2).

8 Manufacturer notes that pH value of propofol is and it can effectively be used between 4-37 C. The aim of this study was to compare the effect of storing propofol at room Temperature or refrigerator on severity of injection local Ethical Committee approval and informed consent obtained, 200 American Society of Anaesthesiologists physical status I-II patients scheduled for gastrointestinal or urological surgeries under general anaesthesiology were included in a prospective randomized, Address for Correspondence/Yaz ma Adresi: Dr.

9 Asl Demir, Clinic of Anaesthesiology, Turkey Y ksek htisas Education and Research Hospital, Ankara, Turkey, Phone: +90 312 306 18 81 E-mail: Telif Hakk 2013 T rk Anesteziyoloji ve Reanimasyon Derne i - Makale metnine web sayfas ndan ula labilir. Copyright 2013 by Turkish Anaesthesiology and Intensive Care Society - Available online at Tarihi / Received : Kabul Tarihi / Accepted : DOI: Demir1, Bahar Ayd nl 1, B ra Tezcan1, Perihan U ar1, Eslem nce1, Derya ztuna2, Asl D nmez1, zcan Erdemli11 Clinic of Anaesthesiology, Turkey Y ksek htisas Education and Research Hospital, Ankara, Turkey2 Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, TurkeyAbstract / zetOriginal Article / zg n Ara t rma34double blind study.

10 All patients were educated on the 6-point verbal rating scale. Patients receiving analgesics or sedative drugs 24 hours prior to surgery and pre-anaesthetic medication, and patients with neurologic deficits, allergy to propofol , cardiovascular instability, lipid metabolism disorder, hepatic or renal problems, and psychiatric disor-ders were not included in the study. On arrival to the operating room, which is consistently kept at 22-24 C via central air-conditioning, a 20-gauge intravenous cannula was inserted into the largest dorsal vein of the patient s non-dominant hand.