THE USE OF LIGNOCAINE TO REDUCE PAIN ON IV INJECTION OF DILUTED NALBUPHINE

A randomized, placebo-controlled, double-blind study was conducted on 66 healthy patients aged 10-61 years undergoing elective ear, nose and throat surgery to assess the incidence and severity of pain associate d with intravenous (i.v.) injection of diluted nalbuphine HCl given du ring induction of general anaesthesia, and to determine the efficacy o f adding lignocaine (2 mg mL(-1)) to nalbuphine to reduce this pain. I njection of saline produced pain of low intensity in 15% of patients a nd a withdrawal response in 3% of patients. Injection of nalbuphine mi xed with lignocaine produced a significantly higher incidence (36%; P< 0.025) and severity (P<0.025) of pain than saline, but a similar numbe r of responses (6%) to pain. The diluted nalbuphine alone produced the highest incidence (61%) of pain (P<0.01 vs. saline, P=NS vs. nalbuphi ne with lignocaine), which was most severe (P<0.01 vs. saline, P<0.025 vs. nalbuphine with lignocaine), and caused the highest number (27%) of withdrawal responses (P<0.01 vs. saline, P<0.025 vs. nalbuphine wit h lignocaine). We conclude that diluted nalbuphine 2 mg mL(-1) produce s pain on i.v. injection into peripheral veins, and that this can be s ignificantly reduced by adding lignocaine 2 mg mL(-1) to the solution.