The Effects of Sufentanil or Remifentanil Pretreatment on Propofol Injection Pain

Background and Propofol produces anesthesia with rapid recovery. However, it causes pain or discomfort during injection. The effect of remifentanil in prevention of propofol-induced injection pain was demonstrated in earlier studies. Sufentanil, an opioid analgesic, has not been studied for managing pain on injection of propofol. We have compared the efficacy of remifentanil and sufentanil for the prevention of propofol induced pain. One hundred twenty American Society of Anesthesiologists (ASA) class I-II adults undergoing elective surgery were randomly assigned into four groups of 20 each. Patients received 2 mL (10 mg) sufentanil, 2 mL of remifentanil (10 mg), 2 mL of remifentanil (20 mg), or 2 mL of saline 60 seconds prior to administering 5 mL of propofol 1%. Patients were asked whether they had pain due to propofol injection.Their pain scores were evaluated with the use of the four-point scale of Ambesh. The remifentanil and sufentanil groups significantly showed lower frequency of pain than that in the saline group (p < 0.05). Median pain intensity scores were significantly lower in the group receiving remifentanil 20 mg compared with the sufentanil groups (P < 0.05). The median intensity of propofol-induced pain was statistically similar between the groups receiving sufentanil or remifentanil 10 mg and the placebo groups. Remifentanil 20 mg over 1 min before propofol administration is more effective than sufentanil 10 mg 1 min prior to propofol in reducing the incidence and intensity of injection pain.