ONDANSETRON V/S METACHLOPRAMIDE FOR ALLEIVATION OF PROPOFOL PAIN. A RANDOMISED CONTROL STUDY

Dr. Amrutha S.*, Dr. Saraswathi Devi

ABSTRACT

Background and Aims: Propofol is widely used for induction of anaesthesia, pain during its injection remains a concern. A number of techniques have been adopted to minimise propofol induced pain. Various 5HT3 antagonists have shown to reduce propofol induced pain, metachlopramide is shown to have analgesic effect and reduce the use of opioids. Both drugs are used commonly for prevention of postoperative nausea and vomiting. A randomised controlled study was conducted to compare the efficacy of ondansetron and metachlopramide in terms of attenuation of propofolinduced pain during induction of anaesthesia. Methods: 100 adult patients aged 20–70 years posted for various elective surgical procedures under general anaesthesia were randomly assigned to two groups of 50 each. Group O received 4 mg of ondansetron, Group M received 10mg of metachlopramide. After intravenous pre‑treatment of study drug, manual occlusion of venous drainage was done at mid‑arm for 1 min. This was followed by administration of propofol (1%) after release of venous occlusion. Pain was assessed with a four‑point scale. Unpaired Student’s t‑test and Chi‑square test/Fisher’s exact test were used to analyse results. Results: Demographic data in both the groups were comparable and there was no statistical significance.VRS and VASwere lower in group M compared to group O. Priming with either ondansetron or metachlopramide mostly alleviated pain of initiation of propofol injection where 17 patients in group O and 36 in group M had no pain. 16 patients in group O whereas only 8 patients in group M had mild pain. VRS of 2 was noted in 11 patients with group O and 3 patients in group M. Priming with 10 mg metachlopramide provided significantly better analgesia compared to ondansetron 4mg with p value of 0.002.

Keywords: Ondansetron, metachlopramide, pain, propofol.