Evaluation of efficacy of valsalva manuever for attenuating propofol injection pain

Aims and objectives: Primary objective: To evaluate the efficacy of valsalva procedure in attenuating propofol injection pain at induction of general anaesthesia. Methodology: Patients will be randomized with the help of a computer-generated table of random numbers into 2 groups of 40 each. Group I (Control): acted as control and did not perform valsalva; Group II (Valsalva): patients blowing into a rubber tubing connected to sphygmomanometer and raise the mercury column up to 30 mmHg for a period of at least 20 sec. Just after the intervention, all the patients will be receiving one-fourth of the total calculated dose of propofol over 5s and 15 s later till 1 minute and before the patients lost consciousness. One nursing staff who will be kept unaware of the study, will assess VAS and withdrawal response score. Exclusion: Patients with communication problem, cardiorespiratory disease, chronic pain disorder, on preoperative analgesic medication, history of propofol allergy, history of drug abuse and inability to perform valsalva Risks associated with the procedure are none as in ASA 1 patients; however, valsalva procedure has been reported to attenuate pain in animal studies and more so in humans for minimizing venous cannulation pain in adults and paediatric patients. We therefore wish to evaluate its efficacy in reducing the propofol injection pain.