A Comparative Study of Ramosetron and Lidocaine in the Attenuation of Propofol Induced Pain in Paediatric Patients ?? A Double Blinded Randomized Study in ESIC Medical College, Kalaburgi


Sumalatha Gangur Basappa1, Ravichandra Ramesh Dodawad2

The incidence of pain on propofol injection varies between 28 – 90 % during
induction and may be severe. Ramosetron has been proved efficacious in reducing
propofol pain in adults but not in children, therefore we conducted this double
blinded randomized controlled study to determine the effectiveness of ramosetron
in attenuating propofol induced pain in children. The purpose of this study was to
compare the effectiveness of injection ramosetron, a 5HT3 antagonist and
lidocaine, the commonest drug for attenuation of pain caused by injection
This is a randomised double-blinded study. Eighty children of American Society of
Anaesthesiologist (ASA) grade I - II, aged 4 - 14 years, undergoing elective
surgical procedures under general anaesthesia were randomly assigned to two
groups of 40 each. Group PR received 6 μg/kg of ramosetron and Group PL
received 0.2 mg/kg of 2 % lidocaine. After injection of study drug, occlusion of
venous drainage was done manually by a trained assistant at mid-arm for 60
seconds. After releasing manual occlusion Injection propofol (1 %) 2 mg/kg was
administered slowly over a period of 5 seconds. A four point scale was used to
assess the severity of pain. The results were analysed by using unpaired student’s
t - test and chi-square test/Fisher’s exact test. P value of < 0.05 was considered
statistically significant.
The demographic characteristics were comparable in both groups. The incidence
of no pain in Group PR and Group PL was 60 % (N = 24) and 65 % (N = 26)
respectively which was comparable. The incidence of mild, moderate and severe
pain was comparable in both groups. The overall incidence of propofol injection
pain in group PL and group PR was 35 % and 40 % respectively (P = 0.862).
Intravenous ramosetron at a dose of 6 μg/kg can effectively attenuate the propofol
induced pain comparable to 0.2 mg/kg of lidocaine in children.