Pretreatment with ketorolac and venous occlusion to reduce pain on injection of propofol

We performed a randomised, double-blind, prospective trial to discover whet her intravenous ketorolac 10 mg made up to 2 mi with saline, with or withou t venous occlusion for 2 min, reduces the pain on injection of propofol. In 90 patients, pain scores were obtained during injection of propofol follow ing pretreatment of the vein with saline, ketorolac or ketorolac with venou s occlusion. Pain on injection of ketorolac was more common than with salin e (p = 0.02). The incidence of severe pain following propofol was reduced b y ketorolac with venous occlusion (p = 0.019) compared with saline or ketor olac without venous occlusion. There was no difference in venous sequelae a t 7 days postoperatively between the groups. Our results suggest that pain on injection of propofol may be related to release of local kininogens and that nonsteroidal antiinflammatory drugs may have a role in reducing that p ain.