Effect of intravenous injection of hydrocortisone and lidocaine 2% on pain after propofol injection: a double-blind randomized clinical trial

Propofol is an intravenous anesthetic drug that has been widely used in outpatient and short-term surgery due to its rapid recovery. However, pain during propofol injection can cause discomfort in 28 to 91% of patients. Various sources have argued that the effects of hydrocortisone and lidocaine on pain during propofol injection are contradictory. The present study was investigated the comparison of effect of hydrocortisone and lidocaine on pain during propofol injection.

In a randomized double-blind clinical trial, 150 patients, aged 15-65 years with ASA I and II physical grade who were candidates for elective surgery under general anesthesia at Shahid Mohammadi Hospital in Bandar Abbas in 2019 were enrolled. They were, randomly divided into 3 groups of 50 subjects'. Group A received lidocaine 2%, 1 mg / kg; group B received 25 mg hydrocortisone; and group C received 5 ml saline. The severity and incidence of pain after propofol injection were evaluated. Data were analyzed by SPSS software, version 19 and analyzed by independent t-test and chi-square or fisher exact test. P-values ​​less than 0.05 were considered as significant.

There was a significant difference in incidence of pain during propofol injection between the three groups (lidocaine and hydrocortisone, lidocaine and hydrocortisone and with normal saline) (p <0.001). There was also a significant difference in pain severity between the lidocaine and hydrocortisone with normal saline groups, while there was no significant difference between the lidocaine and hydrocortisone groups (p= 0.615). The effect of hydrocortisone and lidocaine on pain was not significant according to sex, age and weight.

Hydrocortisone and lidocaine reduce pain during propofol injection and the effect of lidocaine was more than hydrocortisone. However, using of these medications may be able to reduce the pain resulted during propofol injection.