Title: Can adding Ephedrine to Admixture of Propofol & Lidocaine Overcome Propofol Associated Hemodynamic Changes and Injection Pain?
Abstract: Purpose: There are numerous studies researching ways to alleviate propofol injection pain.In this study, we evaluated and compared the use of propofol-lidocaine admixture vs propofol-lidocaine combined with ephedrine, on vascular pain and hemodynamic changes associated propofol.Methods: This double-blinded, prospective, randomised study was performed on 100 patients with ASA I-II who were divided into two group.The first received admixture consisting of 20 mg of lidocaine and propofol 1% 20 ml (Group L), and the other received admixture consisting of 20 mcg ephedrine, 20 mg lidocaine and propofol 1% 20 ml (Group LE).Baseline and after induction heart rate, mean arterial pressure and rate pressure product (RPP) were recorded per minute.Vascular pain were evaluated with verbal rating scale.Results: Data of 40 patients in group L and 39 patients in Group LE were evaluated in the study.The incidence of pain in group L was 90%, it was 38.4% for Group LE.Mild pain was observed significantly more in Group L when compared to Group LE (p<0.05).Average blood pressure and RPP immediately after induction and 1 min after intubation were significantly higher in group LE compared to group L (p<0.05).Heart rate was higher in Group LE immediately after induction and at initially 4 minutes after intubation. Conclusion:Our study has demonstrated significant decrease in rate of vascular pain and increased hemodynamic stability in patients receiving 20 mg ephedrine added to 20 ml % 1 propofol and 20 mg lidocaine admixture when compared to those who only received the lidocaine-propofol admixture.