Randomised controlled trial to compare cisatracurium versus 2%lignocaine preservative free (xylocard) pretreatment with tourniquet to reduce propofol injection pain

AIMSAND OBJECTIVES

 â—       The aim of thepresent study is to investigate the efficacy of pretreatment with 0.15mg/Kg   cisatracurium in the prevention of propol-associated pain injected 30s before propofol injection with venous occlusion athe forearm. The efficacy of cisatracurium will compared with that of 2%preservative free lidocaine

MATERIAL AND METHODS

•          Thisopen label prospective, randomized controlled study will be done at PIMS,Jalandhar after approval from institutional ethics committee on 80 patients(40patients for each group) scheduled to undergo elective non cardiac surgeryunder general anesthesia of ASA physical status I and II aged 18-65 years.

•       Exclusion Criteria: Patient refusal,Allergy to propofol or egg, limited neck mobility; history of difficultintubation; history of cardiovascular, respiratory, neurological, neuromuscularor psychiatric disease.

•      Patients will be randomly divided into two groupsaccording to computer generated randomization.

•      Group-I:- Pretreatment with 2% Lignocaine 0.5mg/Kg(Preservative free)

•      Group-II: - Pretreatment with 0.15mg/Kg cisatracurium.

•       Patient will be taken to the operative room andECG, SPO2, NIBP will be recorded.

•      A 20-G cannula will be inserted into the largestvisible vein on the radial side, attached to a three-way tap and flushed withRinger’s lactate solution.

•      A venous occlusion tourniquet will be applied justabove the elbow and pretreatment drug will be administered in open labelmanner. The tourniquet will be released after 30s. Then 0.5mg/kg propofol willbe delivered via the intravenous cannula. In order to evaluate pain anddetermine the possibility of muscle paralysis, patients will be asked “does ithurt?†by the anesthetist at 10s after the initial propofol dose, and at 20sintervals thereafter until unresponsive. Any spontaneous movement of the wrist,elbow or shoulder will be noted. Pain scores will be evaluated by ananesthetist who will be blinded to group assignment and expressed using afour-point scale:

STATISTICAL ANALYSIS

•      Continuous variables will be expressed as mean ±SD ormedian (range). Categorical variables were described as n (%).

•      Demographic data will be analyzed with one wayanalysis of variance and Scheffe’s post hoc test, or X2-test.

•       Between- groupvariation in the incidence of pain will be analyzed using X2-test.Statistical significant will be defined as P<0.05. Statistical analyses willperformed with SPSS.