Comparative Evaluation of Volatile Anaesthetic Agents for Attenuation of Venous Cannulation Pain: A Prospective, Randomized Controlled Study
Introduction: Topical application of volatile anaesthetic agents has been found to attenuate the response to a mechanical stimulus; however, this effect of volatile anaesthetic on perception of pain during venous cannulation is not known. Aim: To compare the efficacy of topically administered vo...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/8412/19970_CE[Ra]_F(P)_PF1(ROAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Topical application of volatile anaesthetic agents
has been found to attenuate the response to a mechanical
stimulus; however, this effect of volatile anaesthetic on
perception of pain during venous cannulation is not known.
Aim: To compare the efficacy of topically administered volatile
anaesthetic agents for attenuating venous cannulation pain.
Materials and Methods: This prospective, randomized,
placebo controlled and double blind study was conducted on
120 patients, aged 20-60years. They were of American Society
of Anaesthesiologists (ASA) I or II physical status, of either sex,
planned for elective surgeries. These patients were randomized
into 4 groups, of 30 each. Equipotent doses of halothane
(1ml), isoflurane (1.5ml), sevoflurane (2.7ml) and sterile water
(2.5ml; Control) were topically administered on the volar surface
of forearm wrapped with cotton and aluminium foil; venous
cannulation was performed with 18G intravenous cannula after
30 min. These patients were assessed for the incidence and
severity of pain upon venous cannulation {visual analog scale
(VAS), 0-100mm; 0 = no pain and 100 = worst imaginable pain}.
Data were analysed by one-way ANOVA, Chi-square test and
Kruskal-Wallis test. The p<0.05 was considered as significant.
Results: A significant reduction in the incidence of venous
cannulation pain was observed in the halothane (79%) group as
compared to control (100%; p<0.05), isoflurane (100%; p<0.05)
and sevoflurane (100%; p<0.05) groups. The severity of venous
cannulation pain as assessed by median (interquartile range,
Q1-Q3). VAS scores was reduced in the halothane {10 (10-20);
p<0.001}, isoflurane {20 (10-30); p<0.001} and sevoflurane {20
(20-30); p<0.001} groups as compared to the control group {40
(30-40)}; VAS score in the halothane group was significantly less
as compared to isoflurane (p<0.05) and sevoflurane (p<0.05)
groups.
Conclusion: Topical application of halothane is most effective
in reducing incidence and severity of venous cannulation pain;
however, topical application of isoflurane and sevoflurane
decreases only the severity of venous cannulation pain. |
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| ISSN: | 2249-782X 0973-709X |