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Randomized Controlled Trial
. 2021 Nov 4:15:4551-4558.
doi: 10.2147/DDDT.S334100. eCollection 2021.

Efficacy of Pre-Treatment with Remimazolam on Prevention of Propofol-Induced Injection Pain in Patients Undergoing Abortion or Curettage: A Prospective, Double-Blinded, Randomized and Placebo-Controlled Clinical Trial

Xuehai Guan #  1 , Ziyin Jiao #  1 , Xiaofang Gong  1 , Huiyu Cao  1 , Susu Liu  1 , Hongmeng Lan  1 , Xiaofang Huang  1 , Yanmeng Tan  1 , Bing Xu  2 , Chengxin Lin  1
Affiliations
Randomized Controlled Trial

Efficacy of Pre-Treatment with Remimazolam on Prevention of Propofol-Induced Injection Pain in Patients Undergoing Abortion or Curettage: A Prospective, Double-Blinded, Randomized and Placebo-Controlled Clinical Trial

Xuehai Guan et al. Drug Des Devel Ther. .

Abstract

Background: Propofol-induced injection pain (PIP) is a well-known problem in general anesthesia. We hypothesized that pre-treatment with remimazolam prevents PIP in patients undergoing abortion or curettage.

Materials and methods: In this prospective, single-center, double-blinded, randomized, placebo-controlled clinical trial, adult patients aged 18 to 60 undergoing abortion or curettage were randomly assigned to three groups. Group Lido received system lidocaine (a bolus of 0.5 mg kg-1, iv). Group Remi received remimazolam (a bolus of 0.1 mg kg-1, iv). Group NS received identical volumes of 0.9% normal saline. Sixty seconds after the injection of lidocaine, remimazolam or saline, patients were injected with propofol at a rate of 12 mL/min until the loss of consciousness. The primary outcome was the incidence of PIP at the time of induction using 4-point scale. Secondary outcomes included propofol-induced injection pain, vital signs, the characteristics of anesthesia and surgery, and adverse events.

Results: The incidence of patients with PIP was higher in group NS than that in group Lido and group Remi (75.7, 44.3, and 42.9%, respectively, p < 0.001). The percentages of patients with moderate PIP were higher in group NS than that in group Lido and group Remi (20.0, 2.9, and 1.4%, respectively, p < 0.001). Moreover, the consumption of propofol and the incidence of adverse event (hypoxemia and chin lifting) in group Remi were lower than that in group NS and Lido, and less patients got physical movement and cough in group Remi. The recovery time in group NS was longer than that in group Lido and Remi.

Conclusion: Our findings indicate that pre-treatment with remimazolam reduced the incidence and intensity of PIP in abortion or curettage patients, equivalent to that of lidocaine without severe adverse effects.

Trial registration: Chinese Clinical Trial Registry (identifier: ChiCTR2100041805).

Keywords: abortion; curettage; lidocaine; propofol injection pain; remimazolam.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
CONSORT flow of clinical procedures.
Figure 2
Figure 2
Changes of vital signs (A–E).
See this image and copyright information in PMC

References

    1. Wrench IJ, Girling KJ, Hobbs GJ. Alfentanil-mediated analgesia during propofol injection: no evidence for a peripheral action. Br J Anaesth. 1996;77(2):162–164. doi:10.1093/bja/77.2.162 - DOI - PubMed
    1. Mangar D, Holak EJ. Tourniquet at 50 mm Hg followed by intravenous lidocaine diminishes hand pain associated with propofol injection. Anesth Analg. 1992;74(2):250–252. doi:10.1213/00000539-199202000-00014 - DOI - PubMed
    1. Picard P, Tramer MR. Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg. 2000;90(4):963–969. doi:10.1097/00000539-200004000-00035 - DOI - PubMed
    1. Singla B, Malde AD. A prospective observational study of injection pain in children with medium plus long chain triglyceride and long chain triglyceride propofol premixed with lignocaine. Indian J Anaesth. 2018;62(3):214–218. doi:10.4103/ija.IJA_506_17 - DOI - PMC - PubMed
    1. Zirak N, Bameshki A, Yazdani M, et al. Lipid composition and lidocaine effect on immediate and delayed injection pain following propofol administration. Anesth Essays Res. 2016;10(1):29–32. doi:10.4103/0259-1162.164728 - DOI - PMC - PubMed

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