Pretreatment with 6% Hydroxyethyl Starch for Reducing Propofol Injection Pain: A Prospective Randomized Controlled Trial (Code-T0213)

Introduction: Pain on propofol injection (POPI) is a common adverse effect, affecting 30-90% of patients. Various strategies have been explored to minimize this discomfort, yielding inconsistent results. Hydroxyethyl starch (HES), a colloid solution, is hypothesized to reduce pain by modifying endothelial permeability and preventing pain mediator activation. This study evaluates the efficacy of pretreatment with 6% HES in reducing the incidence and severity of POPI.

Aim and Objectives: This study aims to assess the impact of 6% HES pretreatment on POPI. The objectives include comparing the incidence and severity of POPI between patients receiving HES and those receiving normal saline, along with evaluating associated hemodynamic effects.

Methods: A prospective randomized controlled trial was conducted on 120 ASA I-II patients undergoing elective surgery. Participants were randomly allocated to receive either 100 mL of 6% HES or normal saline five minutes before propofol injection. Pain was evaluated using a 0-3 Verbal Rating Scale (VRS), and hemodynamic parameters were monitored. Statistical analysis was performed using SPSS, with p<0.05 considered statistically significant.

Results: The incidence of POPI was significantly lower in the HES group (53.3%) than in the normal saline group (81.7%) (p=0.001). Additionally, the mean pain score was lower in the HES group (0.72±0.76 vs. 1.28±0.83, p<0.001). Hemodynamic stability was maintained in both groups.

Conclusion: Pretreatment with 6% HES significantly reduces both the incidence and severity of POPI without compromising hemodynamic stability. This simple and effective approach enhances patient comfort during anesthesia induction.

Keywords: Propofol, injection pain, hydroxyethyl starch, anesthesia, randomized controlled trial, hemodynamics.