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Dr. Shweta Shelke, Dr. Ajit Gaikwad, Dr. Prashant Bhalekar and *Dr. Deepak Phalgune


Background and Aims: Propofol is the most widely used intravenous anaesthetic agent for induction and maintenance of anaesthesia. However, pain is a major disadvantage with a reported incidence of approximately 70%. Several interventions have been applied to prevent this pain, with variable success. The primary objective of the present study was to compare the efficacy of lidocaine, ketamine and combination of lidocaine and ketamine in reduction of pain of propofol injection. Methods: Ninety patients, aged 18–60 years, scheduled to undergo elective surgeries under general anaesthesia were randomly assigned to three groups of 30 each. Group L patients received 40 mg of Inj. lidocaine, Group K patients received Inj. ketamine 10 mg, whereas Group LK received Inj. lidocaine 40 mg mixed with Inj. ketamine 10 mg. with venous occlusion. Sixty seconds later, the tourniquet was released and 20% dose of propofol was given over 10 seconds. Pain was assessed with 4-point verbal rating scale (VRS). Analysis of variance (ANOVA) and Chi-square test/Fisher's exact test were used to compare quantitative and qualitative variables respectively. Results: The overall incidence and intensity of pain were significantly less in Groups LK and L compared to Group K. The percentage of patients whose VRS was 0 was significantly higher in group LK (25/ 30 – 83.3%) compared to group K (15/ 30- 50.0%) and Group L (20/30- 66.7%). (P = 0.009). Conclusion: Lignocaine and ketamine in combination significantly reduced pain of propofol injection with no untoward side effects as compared to lignocaine or ketamine alone.

Keywords: Lidocaine, ketamine, pain, propofol, verbal rating scale.

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