Propofol infusion rate does not affect local pain on injection

Background: Local pain at the site of an i.v. injection of propofol is a well‐known problem, particularly in infants. This randomised investigator‐blinded crossover study was designed to assess the effect of the i.v. bolus infusion rate on propofol‐induced pain at the site of injection. Methods: Thirty unpremedicated patients scheduled for ear‐nose‐throat or plastic surgery at Malmö University Hospital, Sweden, were given two consecutive 2.0 ml injections of propofol 10 mg/ml (Diprivan^®, AstraZeneca, Sweden/UK), at different infusion rates (0.2 or 1.0 ml/s), immediately before induction of general anesthesia. Half of the patients (n=15) received the first bolus of propofol over 2 s and the second bolus over 10 s, and the other half (n=15) had their injections in reversed order. After each injection, the patient was asked by an investigator to indicate pain intensity on a visual analog scale (VAS) and to report the times of the appearance, maximum point and disappearance of pain. The injections were given approximately 2 min apart. The investigators scoring pain intensity, as indicated by the patients on a 10‐point numerical rate scale, were blinded to the order in which the injections were given, as were the patients themselves. Results: There were no statistically significant differences in the incidence (both 86%) of intensity (median; 25th; 75th percentiles, in VAS units: 3.1; 1.0; 5.3 and 3.3; 1.4; 5.0, respectively) or duration (66±31 and 73±26 s, respectively) of pain between the faster (1.0 ml/s) and slower (0.2 ml/s) bolus infusion rates of propofol studied. Conclusions: We conclude that the i.v. bolus infusion rate of propofol does not influence drug‐induced local pain on injection, at least not within the infusion rate interval studied. Therefore, adjusting i.v. injection speed does not seem to be a clinically useful tool for reducing the intensity or duration of propofol‐induced pain at the site of administration.