Journal of AdvancedMedical and Dental Sciences Research

Aim: The purpose of this study is to examine the impact that pre-administration of 6% hydroxyethyl starch for the decrease of pain has on propofol injection. Material and methods: Adult patients with a physical status I or II according to the American Society of Anesthesiologists, ranging in age from 20 to 62 years old and being of either gender, who were scheduled to undergo elective surgery under general anaesthesia at a tertiary care institute were recruited for this study after their written informed consent was obtained. An 18-gauge cannula was placed under local anaesthesia in one of the patient's veins—either the hand or the forearm—as soon as the patient was brought into the operating room. An anesthesiologist who was not engaged in the research prepared the study medicines, HES or NS, in two syringes each containing 50 millilitres of liquid, which were then transferred to one of the study investigators, who delivered the medication to the patient over the course of three to five minutes. A second investigator who was blinded to the patients' condition evaluated their level of pain every 10 seconds during the propofol injection. The pain was rated as follows: 0-no pain; 1-mild pain evident only on questioning after 10 seconds without any obvious discomfort; and 2-moderate pain that was self-reported by patients within 10 seconds. Results: The research was carried out on a total of 100 patients, 50 of whom were assigned to the HES group and 50 to the NS group. Both groups had similar ages, weights, and other demographic features [Table 1]; there was no significant difference between the two. In general, the incidence of discomfort was considerably greater in the NS group compared to the HES group (50 percent vs. 30 percent; P = 0.002; relative risk 1.61, 95% confidence range 1.21-2.36). The incidence of severe pain was greater in the NS group (6% vs 0%), and the incidence of moderate pain was higher in the NS group (14% vs 6%), while the incidence of mild pain was equivalent (30% vs 24%; NS vs HES) (Table 2.) Between the two groups, there was a significant difference in terms of the level of pain experienced (no pain or mild pain vs moderate or severe pain; P = 0.001 for this comparison). The extent of the difference in pain experienced by each group was significant (0.81). The number required to treat (NNT) in the HES group was 5, which indicates that 5 patients needed to be given HES in order to avoid discomfort during propofol injection in one patient. Conclusion: When compared to injecting with normal saline, the discomfort associated with injecting propofol is greatly mitigated by the pre-administration of 100 mL of 6% HES 130/0.4 three to five minutes before administering propofol.