Which intervention provides the MOST effective reduction of pain on injection when propofol is given through a small hand vein?
- A Pretreatment with intravenous ondansetron
- B Lidocaine, either mixed with the propofol or given immediately before with venous occlusion ✓
- C Cooling the propofol syringe to 4 degrees Celsius
- D Administering the drug through a larger gauge needle
Correct answer: B. Lidocaine, either mixed with the propofol or given immediately before with venous occlusion
Explanation
Pain on injection occurs in up to two thirds of patients and is related to the aqueous phase concentration of propofol. Lidocaine given just before injection or added to the syringe, especially with brief venous occlusion, is the most consistently effective method. Cooling the syringe slows release but is less effective than lidocaine, and ondansetron has no role in preventing injection pain.
Reference: Stoelting's Pharmacology and Physiology in Anesthetic Practice, 5th ed.
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Written and medically reviewed by the StethoPrep medical team.