Effecct Of Pre-filled Syringe And Ampule On Propofol Injection Pain

BackgroundPropofol is widely used for induction of anaesthesia and TIVA because of its rapid onset, short duration of action and favourable profile for side effects. Despite these advantages, pain on injection of propofol is a problem which making patients discomfrotable. About three out of five patients experience pain on injection of propofol, some of them reporting severe pain that could not bear. Some patients recall the induction of anaesthesia as the most painful part of the perioperative period. The concentration of aqueous free propofol is known to be associated with propofol injection pain. Diprivan, a kind of popular lipid emulsion propofol, has two two different prefilled forms, ampoule and prefilled syringe. We are to evaluate the incidence and severity of injection pain caused by propofol of different prefilled forms in relation to the concentration of free propofol in the aqueous phase.MethodsPart1:Patients were randomly divided into two groups, receiving different prefilled forms of propofol. Both patients and anesthesiologists were blind. Age, gender, ASA grade, blood pressure, heart rate, oxygen saturation of blood and the intensity of injection pain were recorded. Compared the incidence and intensity of pain on injection with experimental group and control group.Part2:Diprivan was divided into two groups, prefilled syringe as experimental group while ampoule as control group. Aqueous free propofol concentrations in each sample was measured by high performance liquid chromatography(HPLC) using a C18column (5μm,250X4.6mm) and a methanol-water-methanoic acid mixture as the mobile phase. The flow rate was1ml/min, and components of the column effluent were monitored using an ultraviolet detector at a wavelength of271nm. The lower limit of quantification was10mg/ml.ResultsPart1:Injection pain was evaluated in40patients. Two groups were comparable in age, gender, ASA grade, blood pressure, heart rate and oxygen saturation of blood. The incidence of pain on injection with experimental group and control group was90%and55%,respectively(P<0.05). The intensity of pain was less in the control group than in the experimental group(P<0.05).Part2:10samples were determinated in this test. The aqueous free propofol concentration of experimental group was higher than that of control group(P<0.05). ConclusionsThe incidence and intensity of pain on injection was higher in the experimental group than in the control group. Higher aqueous free propofol concentration of prefilled syringe propofol produce more frequent and severe pain...