Effect prior administration of IV Ondansetron 4 mg with tourniquet 50 torr on pain during propofol injection compared with propofol premixed with Lidocaine 20 mg

HAPSARI, Andrea Ika, dr. Sri Rahardjo, Sp.An-K

2007 | Tesis | S2 Ilmu Kedokteran Klinik (Ilmu Penyakit Dalam)

Rancangan penelitian ini adalah randomisasi dengan pembauatan ganda yang bertujuan menilai efikasi ondantron 4 mg atau lidocain 20 mg yang dicampur propofol dengan tourniquet 50 Torr untuk mengurangi nyeri injeksi propofol. Segera paska pembendungan vena dengan tourniquet pada lengan pasien suntikan IV normal saline 0.9% 2 cc (Group L, n=55) atau ondasetron 4 mg (Group 0, n = 55) pada 110 adult patients. Pelepasan oklusi vena dilakukan setelah 30 detik dan diikuti pemberian 5 cc intravenous propofol 2 mg.kg-1 (Group 0) atau propofol 2 mg. kg-1 yang dicampur kidocaine 20 mg (Group L) pada kecepatan 1m2 mg.S-1 melalui 18 G di vena dorsum manus. Penilaian nyeri dinilai di kamar operasi dan di ruang pemuliahan recovery. Penilaian ini terdiri atas: gerakan tangan, respon verbal spontan, mengeluh dan menagis selama penyuntikan propofol. Beratnya nyeri dinilai dengan Mc Cririck pain scale ondansetron dapat digunkan sebagai alternative lidocaine untuk mencegah nyeri injeksi propofol.

BACKGROUND AND OBJECTIVES: The study design was a randomized in double blind manner , in order to assess the efficacy of intravenous (IV) pretreatment with ondansetron 4 mg , or lidocaine 20 mg mixed with propofol with tourniquet 50 torr in reducing propofol injection pain. METHODS: Immediately after venous occlusion with a rubber tourniquet on the patient’s arm IV normal saline 0,9 % 2 cc (Group L, n = 55, )or iv ondansetron 4 mg (Group O, n = 55) will be given to 110 adult patients. The release of the venous occlusion was done after 30s and was followed by 5 cc intravenous administration of propofol 2 mg.kg-1 ( Group O) or propofol 2 mg.kg-1 premixed with lidocaine 20 mg ( Group L) at rate of 1,2 mg.s-1 through a 18 G catheter inserted in hand dorsum vein. Pain assessment was made during the propofol injection and for pain recalling in recovery room. These assessment included : movement of hand, spontaneous verbal expressions of pain, frowning, and moaning during the injection of propofol. OUTCOME MEASUREMENT: The pain severity was assessed using Mc Cririck pain scale Pain was assessed with a four-point scale: 0 _ no pain, 1 _ mild pain, 2_moderate pain, and 3_severe pain at the time of propofol injection RESULTS: Seventeen patients (15,45%) complained of pain in the group pretreated with ondansetron as compared with 19(17,27%),in the groups using propofol premixed with lidocaine 20 mg,but the differences were not significant. Ondansetron 4 mg did not reduce the severity of pain compared to lidocaine 20 mg. (p >0.05)

Kata Kunci : Nyeri Penyuntikan Propofol,Ondansetron,Lidocaine,propofol pain injection, ondansetron, lidocaine