Pharmacological control of pain during propofol injection: a systematic review and meta-analysis

ABSTRACT

Objective

A research was performed to review the effect of pharmacological interventions to control the propofol injection pain.

Methods

A search of databases was performed. Randomized clinical trials comparing pharmacological interventions with placebo or active compound to reduce of propofol injection pain were selected. The outcome was the frequency of pain. Data were analyzed in three subgroups according to type of control. Random effect model was used to calculate relative risk (RR) with 95% confidence intervals (CIs).

Results

Fifty-two articles with 105 studies on 7315 adults were included. The incidence of pain in intervention and control group was 40.91% and 66.27%. Combination therapy with two drugs (RR = 0.29 95% CI = (0.11, 0.75)), opioids (RR = 0.39 95% CI = (0.28, 0.54)) and 5 HT3 antagonists (RR = 0.39 95% CI = (0.30, 0.50)) were the most effective interventions compared to placebo. Combination therapy was the most effective intervention compared to lidocaine as control (RR = 0.51 95% CI = (0.46, 0.55)). Opioids were the most effective intervention compared to long chain triglyceride propofol as control (RR = 0.27 95% CI = (0.15, 0.49)).

Conclusion

Pretreatment with two different drugs, opioids and surprisingly 5 HT3 antagonists were the most effective interventions compared to placebo. Combination therapy was the most effective versus lidocaine as control.

KEYWORDS:

• Propofol
• pain
• drug
• meta-analysis

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Elham Bakhtiari, Mohammad Gharavifard: conception and design

Elham Bakhtiari, Mohammad Gharavifard, Seyed Hadi Mousavi: acquisition, analysis

Elham Bakhtiari, Mohammad Gharavifard, Seyed Hadi Mousavi: drafting the work

Elham Bakhtiari, Mohammad Gharavifard, Seyed Hadi Mousavi: final approval

Additional information

Funding

This paper was funded by Mashhad University of Medical Sciences, Mashhad, Iran.