Original Research Article DOI: 10.18231/2394-4994.2018.0088 Indian Journal of Clinical Anaesthesia, October-December, 2018;5(4):461-464 461 A study to evaluate comparative efficacy of two different venous occlusion duration on pretreatment with Inj. lignocaine to prevent propofol Inj. pain in patients undergoing surgery under general anaesthesia Atlanta Talukdar 1 , Sara Mary Thomas 2,* , Akhilesh Chhaya 3 , Dinesh K Chauhan 4 1 PG Resident, 2 Assistant Professor, 3 Professor, 4 Head and Professor, Dept. of Anaesthesiology, SBKS Medical Institute and Research Center, Vadodara, Gujarat, India *Corresponding Author: Sara Mary Thomas Email: sara.cinosh@gmail.com Received: 4 th May, 2018 Accepted: 3 rd July, 2018 Abstract Aim: To study the efficacy of two different time duration of venous occlusion in preventing propofol injection pain. Materials and Methods: In this prospective, randomized controlled study patients of either gender, scheduled to undergo elective surgery under general anaesthesia were randomly assigned into 2 groups (Group L30 and Group L60) of 25 patients each. Group L30 and Group L60 received Injection (Inj) Lignocaine 40mg intravenously under venous occlusion for 30 seconds and 60 seconds respectively followed by Inj propofol for induction. propofol induced pain was assessed after administration of 25% of total calculated dose of propofol. Results: In our study, significantly more patients in Group L30 (72%) reported pain as compared to Group L60 (32%). (p < 0.05). Considering the severity of pain, in Group L30, out of 72% who had pain; 64% had mild pain and 8% had moderate pain. Whereas in Group L60, 32% had pain and all had mild pain only. Conclusion: The study found that pretreatment with Inj Lignocaine 40 mg under venous occlusion for 60 seconds followed by Inj propofol for induction significantly reduced the incidence and the severity of pain of propofol injection when compared with the group who received 40 mg of Inj. Lignocaine under venous occlusion for 30 seconds. Keywords: Propofol injection, Pain, Local anesthetic, Lignocaine, Venous occlusion. Introduction Propofol is a rapidly acting intravenous anaesthetic agent, which is used widely as an induction agent for general anaesthesia due to its smooth induction and rapid recovery properties. However, propofol has its drawbacks as it has been reported to cause substantial pain on Injection (Inj). 1 The incidence of the propofol injection pain varies between 28% and 85%. 1 Several methods have been administered over the years to reduce the pain associated with Intravenous (IV) injection of propofol. 1 These include: non-drug category, 1 drug category and conjunction of the two. 1 The non-drug category includes the studies that used mechanical incessions such as injection sites, 2 needle sizes, 3 temperature, 4 venous occlusion, 5 bacteriostatic, 6 microfiltration. 7 The most effective was the selection of an antecubital vein contrast to a hand vein as the injection site. 8 The drug category constituted various drugs or drug combination for example. Benzodiazepines, 1 Local Anaesthetics, 9 Barbiturates 10 and most of these drugs were partially productive in reducing the pain from propofol injection. A lidocaine - propofol admixture (25 trials) 10 was found the most potent intervention. 10 Ketorolac, 11 Diclofenac, Ketamine, Flurbiprofen were the prime agents explored for potential reduction of pain from propofol injection. The combined drug and non-drug category incorporated non-drug techniques such as venous occlusion, 8 alteration of temperature 4 of propofol 4 and site of injection. 2 The most commonly studied intervention was venous occlusion 8 in conjunction with various drugs such as antiemetics, 9 non-steroidal anti- inflammatory drugs, 12 ketamine, lidocaine, and Opioids 13 for reducing the risk of pain from propofol injection. In this category pretreatment using lidocaine 14 combined with venous occlusion was found to be the most effective intervention at preventing the pain from propofol injection. The duration of 60 seconds have been studied and is believed to allow enough time for the drug to act locally. 4 Hence, we planned to do a comparative study of effect of different time duration of venous occlusion 14 by applying a tourniquet for 30 seconds and 60 seconds 14 on pre treatment with Inj Lignocaine in prevention of propofol injection pain in patients undergoing surgeries under general anaesthesia. Materials and Methods After obtaining approval of the ethics committee and written informed consent from patients, 14 50 American Society of Anaesthesiology (ASA) Grade I & II patients of either gender, aged 18 to 55 years