COMPARATIVE EFFICACY OF CODEINE AND ARTICAINE IN REDUCING PROPOFOL-INDUCED PAIN: A RANDOMIZED, DOUBLE-BLIND STUDY

Abstract

Background: Patient satisfaction with perioperative care is a mandatory point, and one of the most frequent issues is the pain related to the usage of propofol injection, which occurs in 40-86 percent of patients. Promptly to treat this pain, articaine (LID) pre-treatment is regularly utilized, though it has been reported to cause the destabilization of the propofol emulsion, as well as the possible dangers of developing pulmonary fat embolism. In this study, the efficacy of an opioid with agonist-antagonist properties Codeine (DEZ) was examined against LID and placebo (normal saline) in the pain reduction of propofol injection. Methods: It was a placebo-controlled, double-blind and randomized study of 98 patients age: 16-65years whose procedure is: elective surgery under general anesthesia. Three random groups were created which comprised a Control (normal saline) and which was offered in Articaine (40 mg) and Codeine (2 mg). The extent of pain during the administration of propofol was determined using the assistance of the Verbal Rating Scale (VRS), and the pain was assigned a number of 0 (no pain), 1 (mild pain), 2 (moderate pain) or 3 (severe pain). Chi-square and analysis of variance were performed to perform statistical analysis on statistical data of the <lov_ climbing volume and effects of the <elle_ climbing volume and effects of the Results: The percentage occurrence as well as the magnitude of propofol-caused pain was highly minimized in LID and in DEZ groups when compared to the Control group. No pain was registered by 18.18 percent of the patients in the Control group, 60.61 percent and 71.88 percent of patients in the LID and DEZ groups respectively. The administration of DEZ demonstrated the most and significant reduction of pain, as none of the patients experienced severe pain, which is in contrast to 6.06% of the LID group. Conclusions: The pre-treatment with 2 mg Codeine has the same effect as 40 mg Articaine in lowering the cases and level of pain of propofol injection. It is possible that the analgesic action of DEZ is a centrally mediated partial agonist of μ-opioid receptor. DEZ seems to be a potential solution to replacement of Articaine in the treatment of pain associated with propofol, but there should be additional research with different dosages of DEZ and power analysis to determine the optimum dose, and define whether it is effective enough to be used clinically.