Effect of Local Warming versus Local Cooling on Injection Pain After Propofol Administration During Anaesthesia Induction

After obtaining local research ethical committee approval and patients’ informed written consent, 120 patients were studied between age groups of 18 and 65 years old, of ASA groups I and III, and who were scheduled for elective surgery under general anesthesia . The exclusion criteria were; being pregnant and breastfeeding women, having a medical history of epilepsy, having cardiac conduction failure,having lipid metabolism disorder, receiving antiarrhytmic or analgesic drugs, having liver or kidney failure, being allergic to propofol and difficulty for iv cannulation. Without any premedication, the patients were given, 5 ml/kg/hour crystalloid solution, through a 20 G iv cannule which is attached on the dorsum of the hand. Patients in the operation room were monitored for; standard electrocardiography (ECG), blood pressure non invasively and peripheral oxygen saturation (Drager;Infinity delta MS13466E539D,USA). The patients were randomly allocated, using sealed envelopes, to one of following 3 groups of 40 each: 1. Local warming group , (Group I): Before anesthesia induction patients were subjected to 40 degrees C hot application for 2 minutes with a bair hugger device (a device blowing hot air through a blanket to be worn over the body), through the vein trace which the cannula were attached. 2. Local cooling group (Group II): Before anesthesia induction patients were subjected to +2-4 degrees C cooling application for 2 minutes with cold water bags kept in refrigerator, through the infusion vein trace. 3. No intervention group (Group III): Patients in this group were accepted as control group and were not subjected to any procedure. Propofol prepared in room temperature (10 mg/ml ampoule, Fresenius) were administered as 2,5 mg/kg dose and within one minute to all groups. On the 15th second with the start of injection, the patients were asked about suffering any pain. Findings observed until the injection finished and the response was recorded according to the 5-point Verbal Rating Scale (VRS) (0= no pain, 1= mild pain, 2= moderate pain, 3= severe pain, 4= severe pain accompanied by facial grimacing and arm withdrawal).. After propofol injection, opioid and muscle relaxant (only for patients who will be intubated) were given Then the operation progressed with an intubation or a laryngeal mask. Hemodynamics were measured and recorded at control (T0), 1.(T1), 2.(T2), 3.(T3) minutes.