EFFECT OF PRETREATMENT WITH KETAMINE ON PROPOFOL INJECTION PAIN IN CHILDREN

Administration of lignocaine, either belbre or mixed with propofol remains the most widely used method to attenuate this pain on injection of propofol. Ketamine has local anaesthetic action and in lower doses it retains its analgesic properties. This prospective randomised, double blind trial was designed to assess the effectiveness of pre-treatment with ketamine which has local anaesthetic property compared with propofol premixed with lignocaine in minimizing pain on injection in healthy premeditated children between the age group of 5-12 years. Patients were allocated randomly to one of the three groups: group blignocaine 10 mg added to 100 trig propel-cot group II ketamine 5 mg of IV 30 seconds prior to propofol; or group III placebo (normal saline). During the injection of propofol (3 mgkg') the pain perception was assessed with a four point behavioural scale: none, mild, moderate or severe. There were 52 patients in group I, 51 in group II and 52 in group M. The incidence of propofol induced pain was 44/52 (84.6%) in the saline group and could be reduced significantly by using ketamine (15/51, 29.4%) or lignocaine (20/52. 38.4%) (p <0.01). There was no statistically significant difference in incidence of pain between the groups receiving ketamine and lignocaine though the difference appears to be clinically significant. Pain intensity was significantly less in children who received ketamine and lignocaine as compared to placebo (p <0.05). Our results indicate that pre-treatment with small dose of IV ketamine given 30 seconds before propofol injection, reduces pain in 70 % (36/52) of children between the age group of 5-12 years.