Comparison Between Intravenous Nalbuphine and Lidocaine in Reducing Propofol-Induced Injection Pain During Gastroscopy:

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ORIGINAL RESEARCH

Comparison Between Intravenous Nalbuphine and Lidocaine in Reducing Propofol-Induced Injection Pain During Gastroscopy: A Randomized Controlled Trial Jiang Wang . Jinjuan Duan . Cuiyu Xie . Yongqi Yu . Yao Lu

Received: July 2, 2020 Ó The Author(s) 2020

ABSTRACT Introduction: Intravenous propofol anesthesia is widely used in painless endoscopy. However, propofol injection pain is a common adverse effect. This study investigated the effects of nalbuphine and lidocaine in reducing propofolinduced injection pain. Methods: In this double-blind, randomized study, 330 patients were randomly divided into three groups by using a random number table: the nalbuphine group (N), lidocaine group (L), and control group (C). The N, L, and C groups received either 0.1 mg/kg nalbuphine, 0.5 mg/ kg lidocaine, or an equivalent volume of normal saline, respectively, as pretreatment drug. Then

Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12681866. J. Wang  J. Duan  C. Xie  Y. Yu  Y. Lu (&) Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China e-mail: [email protected] J. Duan Department of Anesthesiology, Affiliated Anqing Hospital of Anhui Medical University, Anqing, Anhui Province, People’s Republic of China

propofol was manually injected. The primary outcome of this study was the incidence of propofol-induced injection pain, and secondary outcomes included the severity of propofol-induced injection pain, vital signs, and adverse events, including hypotension, bradycardia (\ 50 beats/min), hypoxemia (SpO2 \ 90%), drowsiness, physical movement, and cough. Results: The percentages of patients with propofol injection pain were higher in group C than in group N and group L (64, 34, and 27%, respectively, p \ 0.05). The percentage of patients with severe pain after propofol injection was significantly higher in group C than in group N and group L (12, 1, and 0%, respectively, p \ 0.05). The doses of propofol in group C and group L were significantly higher than that in group N. More patients suffered hypoxemia in group N than in group C and group L. Then, less patients got physical movement and cough in group N. Conclusions: Pretreatment with nalbuphine 0.1 mg/kg was effective in reducing propofol-induced injection pain and propofol consumption. Propofol combined with nalbuphine can be safely and effectively used during gastroscopy. Trial Registration: Chinese Clinical Trial Registry; ChiCTR1900025438. Keywords: Gastroscopy; Lidocaine; Nalbuphine; Propofol injection pain

Pain Ther

Key Summary Points Why carry out this study? Propofol is widely used in painless endoscopy anesthesia, however, the incidence of pain induced by propofol injection range from 28 to 90% in untreated patients. Nalbuphine, a synthetic agonist and antagonist analgesic that exerts its pharmacological effects mainly through activation of j receptors and partial antagonism of l receptors, has also been