Abstract
BACKGROUND AND AIMS: Pain on propofol injection (POPI) leads to intense patient discomfort during the induction of anesthesia. This study aimed to compare the efficacy of intravenous dexmedetomidine and topical cold thermotherapy in the relief of POPI. MATERIAL AND METHODS: This randomized controlled trial was conducted on 274 adults undergoing elective surgery under general anesthesia. Patients received dexmedetomidine (0.25 µg/kg) following the application of a tourniquet proximal to the intravenous cannulation site for 30 s (Group D, n = 137), or an ice pack gel (260 mm × 125 mm) was applied proximal to the site of the cannula for 1 min (Group T, n = 137). The primary objective was to assess and compare the incidence and severity of POPI using the McCrirrick and Hunter Scale. The secondary objectives included the comparison of the induction dose of propofol and the hemodynamics (heart rate, blood pressure) at induction, along with the assessment of the presence of discomfort following ice gel pack application. RESULTS: The incidence of pain was greater in Group D as compared to Group T (54.74% v/s 29.17%, P < 0.001). The severity of pain was also greater in Group D as compared to Group T, (pain scores ≥2, Group D v/s T,33 (24%) v/s 5 (3.6%), P < 0.001). The incidence of pain scores 1 and 2 was also higher in Group D as compared to Group T [pain score 1: 42 (30.7%) v/s 35 (25.5%), P = 0.348; pain score 2: 27 (19.7%) v/s 4 (2.9%), P < 0.001]. There was no significant difference in the induction dose of propofol and hemodynamic variables between the groups. CONCLUSION: The application of ice gel pack thermotherapy is associated with a significant reduction in POPI as compared to pre-treatment with dexmedetomidine (0.25 µg/kg), with no significant adverse effects.