Comparison of Efficacy of Lignocaine versus Tramadol in Keeping the Patients Pain Free of Propofol Induced Pain

Abstract

Background: All anesthetists deal with the persistent challenge of pain from propofol injection despite many attempts to solve it through various formulations and trials. While tramadol is commonly used to manage propofol induced pain, its side effects limit its effectiveness. Some studies suggest that using lignocaine before propofol is more efficient than tramadol, although this remains controversial. This study aimed to compare lignocaine and tramadol in preventing propofol-induced pain.

Methodology: Research was conducted at Lahore General Hospital from April 2019 to March 2020. 288 ASA class I and II patients were included, aged 18-60 undergoing general anesthesia with propofol induction. They were split into two groups: Group-A received lignocaine and Group-B received tramadol before propofol injection. Pain levels were evaluated using a verbal rating scale. The study focused on drug effectiveness in maintaining a pain-free state (VRS ≤4) during propofol injection and compared outcomes between the groups. Consent was obtained from each patient.

Results: The mean patient age was 40.42±12.50 years, with mean BMI of 27.85±3.82 Kg/m2. Male patients were 41.3% and females 58.7%, ratio 1:1.4. ASA Class-I had 47.6% and ASA Class-II 52.4% patients. Efficacy in propofol induction was higher in lignocaine vs. tramadol (92.4% vs. 75.7%; p<0.001), consistent across subgroups by age, gender, ASA, and BMI.

Conclusion: In this study, prophylactic intravenous lignocaine was more effective than traditional tramadol in maintaining pain control during propofol induction. Lignocaine's safety record and hemodynamic benefits support its future use in anesthesia.