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VOLUME 2 , ISSUE 2 ( July-December, 2017 ) > List of Articles


Pain Perception following Administration of Propofol with 7.5 mg Ephedrine, 15 mg Ephedrine, or Lignocaine— A Comparative Study

Indrani H Chincholi, Sonali D Patira

Citation Information : Chincholi IH, Patira SD. Pain Perception following Administration of Propofol with 7.5 mg Ephedrine, 15 mg Ephedrine, or Lignocaine— A Comparative Study. Res Inno Anesth 2017; 2 (2):58-63.

DOI: 10.5005/jp-journals-10049-0034

License: CC BY 3.0

Published Online: 01-01-2013

Copyright Statement:  Copyright © 2017; The Author(s).



Propofol is the drug of choice for induction of anesthesia because of its rapid onset, easy titration, and short duration of action. However, pain on propofol injection is an unpleasant experience felt by many of our patients. Many factors have been investigated to decrease the pain on propofol injection but it is still a mystery.


To compare the effect of two doses of ephedrine (7.5 and 15 mg) and lignocaine on pain during injection of propofol and to compare their hemodynamic parameters and note for any complications.

Materials and methods

This study was a prospective, randomized, double-blinded, single-center study on 150 adult patients of both the sexes belonging to American Society of Anesthesiologists (ASA) grades I and II for elective surgery under general anesthesia. The aim was to compare the analgesic effect of lignocaine, ephedrine 7.5 and 15 mg in ameliorating propofol injection pain. About 50 patients were allocated to each of the three groups receiving lignocaine 2% (1.5 mL), ephedrine 7.5 mg, and ephedrine 15 mg intravenously admixed with propofol. The intensity of pain at the time of propofol injection was assessed using verbal rating scale (VRS) 4-point scale before the patient lost consciousness.

Statistical analysis

Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) version 22.0 software. The qualitative data were summarized as frequency and percentages. The Fischer exact test was used to analyze the data. The continuous data were summarized as mean and standard deviation. The group and intergroup analyses were done using repeated measures analysis of variance (ANOVA) test. A p-value <0.05 was considered significant.


Median (interquartile range) of the pain score was 1 (2) in group E-7.5 mg, 0 (1) in group E-15 mg, and 0(1) in group L. Results were statistically significant.


Adding 15 mg ephedrine was as effective as adding lignocaine for the prevention of propofol injection pain and ephedrine had a better and stable hemodynamic profile.

How to cite this article

Chincholi IH, Madan HK, Patira SD. Pain Perception following Administration of Propofol with 7.5 mg Ephedrine, 15 mg Ephedrine, or Lignocaine—A Comparative Study. Res Inno in Anesth 2017;2(2):58-63.

  1. Miller's anaesthesia. 7th ed. Philadelphia, PA: Churchill Livingstone; 2009. p. 720-728.
  2. Venous occlusion with lignocaine for preventing propofol induced pain. A prospective double-blind randomized study. Saudi Med J 2006 July;27(7):997-1000.
  3. Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg 2000 Apr;90(4):963-969.
  4. Ephedrine reduces the pain from propofol injection. Anaesth Analg 2002 Nov;95(5):1293-1296.
  5. Adrenoreceptor-activating and other sympathomimetic drugs. In Bertram GK, editor. Basic & clinical pharmacology. 10th ed. New York, NY: McGraw-Hill Publications; 2007.
  6. Prophylactic ephedrine during spinal anaesthesia: double-blind study in patients in ASA groups I–III. Br J Anaesth 1989 Sep;63(3):340-342.
  7. Pain on injection of propofol: the effect of injectate temperature. Anesthesia 1990 Jun;45:443-444.
  8. Pain on injection of propofol. Anaesthesia 1998 May;53(5):468-476.
  9. Lidocaine for the prevention of pain due to injection of propofol. Anaesth Analg 1992 Feb;74(2):246-249.
  10. Reduction of propofol injection pain with a double lumen i.v. set. J Clin Anesth 1997 Sep;9(6):462-466.
  11. Profound pain due to propofol injection triggered bronchospasm in a smoker—a case report. Middle East J Anaesthesiol 2006 Jun;18(5):939-942.
  12. Profound pain due to propofol injection triggered myocardial ischemia in a patient with a suspected pheochromocytoma. Anesth Analg 2003 Feb;96(2):631.
  13. Prevention of pain on injection of propofol: systematic review and meta-analysis. BMJ 2011 Mar;342:d1110.
  14. The haemodynamic effects of propofol in combination with ephedrine. Anaesthesia 1996 May;51(5):488-491.
  15. Preventing pain on injection of propofol: a comparison between lignocaine pre-treatment and lignocaine added to propofol. Anaesth Intensive Care 2004 Aug;32(4):482-484.
  16. Admixture of ephedrine to offset side effects of propofol: a randomized, controlled trial. J Clin Anesth 2009 Feb;21(1):44-49.
  17. The effect of combined ephedrine and lidocaine pretreatment on pain and hemodynamic changes due to propofol injection. Acta Anaesthesiol Taiwan. 2011 Jun; 49(2):54-58.
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