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The Peripheral Analgesic Effect of Tramadol in Reducing Propofol Injection Pain: A Comparison With Lidocaine
  1. Wei-Wu Pang, M.D.,
  2. Pok-Yan Huang, M.D.,
  3. Da-Peng Chang, M.D. and
  4. Min-Ho Huang, M.D.
  1. From the Department of Anesthesia, Show-Chwan Memorial Hospital, Changhua, Taiwan, R.O.C.
  1. Reprint requests: Wei-Wu Pang, M.D., Department of Anesthesia, Show-Chwan Memorial Hospital, Chung-Shang Road, 542 Section 1, Changhua, Taiwan, R.O.C.


Background and Objectives. Tramadol and metoclopramide have a local anesthetic effect similar to lidocaine following intradermal injection. When metoclopramide was retained in the venous system for 1 minute, it was found to be as effective as lidocaine in reducing propofol injection pain. Using this metoclopramide model, the effects of tramadol in reducing pain on propofol injection was investigated.

Methods. One hundred five patients were randomly allocated to receive 50 mg tramadol (group T), 60 mg lidocaine (group L), or normal saline (group NS) as pretreatment to reduce pain on propofol injection. Following venous occlusion with a tourniquet (70 mm Hg), one of the drugs was intravenously administered. Venous retention of the drug was maintained for 1 minute. Immediately after the tourniquet release, intravenous injection of 100 mg propofol (10 mL) at a rate of 0.5 mL/s followed. Pain assessment was made after each injection.

Results. Transient minor injection pain and local skin reactions were significantly greater with tramadol than with lidocaine (P < .05). Both tramadol and lidocaine significantly reduced the incidence and intensity of propofol injection pain when compared with normal saline (P < .05).

Conclusions. Using 1-minute retention in veins, both tramadol and lidocaine significantly reduced propofol injection pain. A local anesthetic activity is postulated.

  • propofol
  • injection pain
  • tramadol
  • peripheral analgesic effect.

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  • This study was done at the Show-Chwan Memorial Hospital, Changhua, Taiwan.