Which intravenous induction agent produces the highest incidence of pain on injection?

• A Ketamine
• B Etomidate
• C Thiopentone
• D Propofol ✓

Explanation

Propofol causes pain on injection in 30 to 90 percent of patients, worst when given into small hand veins. Incidence falls with lidocaine pretreatment, mixing lidocaine with propofol, using a large forearm vein, or prior venous occlusion. Etomidate also burns because of its propylene glycol vehicle but less frequently than propofol. Thiopentone is painless unless extravasated, and ketamine causes negligible injection pain.

Reference: Morgan and Mikhail's Clinical Anesthesiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.