The peripheral analgesic effect of tramadol in reducing propofol injectionpain: A comparison with lidocaine

Background and Objectives. Tramadol and metoclopramide have a local anesthe tic effect similar to lidocaine following intradermal injection. When metoc lopramide was retained in the venous system for 1 minute, it was found to b e as effective as lidocaine in reducing propofol injection pain. Using this metoclopramide model, the effects of tramadol in reducing pain on propofol injection was investigated. Methods. One hundred five patients were random ly allocated to receive 50 mg tramadol (group T), 60 mg lidocaine (group L) , or normal saline (group NS) as pretreatment to reduce pain on propofol in jection. Following venous occlusion with a tourniquet (70 mn Hg), one of th e drugs was intravenously administered. Venous retention of the drug was ma intained fnr 1 minute. Immediately after the tourniquet release intravenous injection of 100 mg propofol (10 mt) at a rate of 0.5 mL/s followed. Pain assessment was made after each injection. Results. Transient minor injectio n pain and local skin reactions were significantly greater with tramadol th an with lidocaine (P < .05). Both tramadol and lidocaine significantly redu ced the incidence and intensity of propofol injection pain when compared wi th normal saline (P < .05). Conclusions. Using 1-minute retention in veins, both tramadol and lidocaine significantly reduced propofol injection pain. A local anesthetic activity is postulated.