Large Antecubital Vein Versus Small Vein on Dorsum of Hand for Propofol Injection Pain: A Comparative Study

Abstract

Objective: To determine the mean difference in pain scores between large antecubital vein compared to the small vein on hand dorsum for propofol injection pain in patients undergoing general anaesthesia surgery.
Methods: A randomized control trial was conducted at the Department of Anaesthesiology, Abbasi Shaheed Hospital, Karachi from May 2018 to November 2018. All patients aged 18-60 years of either gender undergoing scheduled elective surgery under general anaesthesia having ASA status I or II were consecutively enrolled. Group A was offered propofol through the antecubital vein and group B was given injection propofol through a small vein on the dorsum of the hand. The 2% lidocaine 1 ml admixture in 1% propofol 19 ml was administered to patients through the large antecubital vein and small dorsal
vein at hand. Anaesthesia induction was carried out as routine and as per the procedure. All patients were explained the use of VAS (Visual Analogue Scale) and were asked to report the intensity of the pain immediately after the injection propofol.
Results: Of 120 patients, the overall mean age and BMI of the patients was 40.92 ± 10.03 years and 27.11 ± 5.05 kg/m2 respectively. An insignificantly higher mean difference of age (p= 0.052) and body mass index (BMI) (p= 0.901) were observed in small vein group as compared to the antecubital group. There were 64 (53.3%) males and 56 (46.7%) females. There were 43 (35.80%) smokers, 52 (43.3%) hypertension (HTN), and 29 (24.2%) diabetes mellitus patients. The mean difference of pain was significantly lower in the antecubital vein group as compared to the small vein group, i.e. 2.48 ± 0.77 vs 5.67 ± 0.75 respectively (p<0.001).
Conclusion: A significant difference in mean pain scores was observed between large antecubital vein versus small vein on hand dorsum for propofol injection pain among patients undergoing surgery for general anaesthesia. We recommend using larger veins for propofol bolus while inducing general anaesthesia patients.