Research Article
Volume 5 Issue 6 - 2021
Chilly Feeling Verse Warm Feeling in Increasing Propofol Injection Pain in Pain-Free Bronchoscopy
Yutao Liu, Fan Ouyang, Bin Zeng and Zhiming Zhang*
Department of Anesthesiology and Operating Room, Chenzhou No.1 Peoples’ Hospital, Chenzou City, Hunan Province, China
*Corresponding Author: Zhiming Zhang, Department of Anesthesiology and Operating Room, Chenzhou No.1 Peoples’ Hospital, Chenzou City, Hunan Province, China.
Received: April 14, 2021; Published: May 25, 2021


Background: Patients will have a different feeling about the same temperature. This feeling will have some effect on the physiological reaction. The purpose of this research is to testify this question: Will chilly feeling enhance the pain induced by propofol injection?

Participants and Methods: One hundred and ninety-one patients with ASA physical status at I to II scheduled for pain-free Bronchoscopy underwent general anaesthesia were included in this research. The temperature of the operating room was set to 22℃ and a 22 G vein cannula was inserted into a vein on the dorsum of the hand. Patients were allocated into 3 groups according to their feeling on the set temperature: Group W (patients reported with warm feeling), Group J (patients reported with just right) and Group C (Patients reported with chilly or cold feeling). After an average of three times of measurements, core temperature was recorded from ear temperature with a portable infrared thermometer. A temperature probe was patched in the centre of injecting hand, to get peripheral temperature. Propofol (1%) 2 mg/kg for inducing was injected by a pumper at a speed of 5 ml/min. Injection pains were recorded following 0 for no pain, 1 for mild pain, 2 for moderate pain or severe pain and 20 mg 0.5% lidocaine was injected for pain-relieving reinforcements. A nasal catheter oxygen supply at 2 L/min was maintained.

Results: (1) Total incidence of injection pains in all of the patients was 68% (130/191) including pain scale at 1 to 2 in our study; (2) Incidence of injection pain in group Chilly was significantly higher than that in Group Just and Group Warm (p < 0.05); (3) No significant difference was found among three groups in Central temperature; (4) Pain Intensity of injection in group Chilly was significantly severe than that in Group Just than Group Warm (p < 0.05).

Conclusion: Comparing to warm and just right feeling, Patients with normal core temperature but the chilly feeling will suffer more frequent and intense Propofol-induced injection pain during the induction procedure of general anaesthesia.

Keywords: Feelings; Chilly; Temperature; Propofol; Injection Pain


  1. Liu R., et al. “Efficacy and Safety of FospropofolFD Compared to Propofol When Given During the Induction of General Anaesthesia: A Phase II, Multi-centre, Randomized, Parallel-Group, Active-Controlled, Double-Blind, Double-Dummy Study”. Basic and Clinical Pharmacology and Toxicology 1 (2016): 93-100.
  2. Gardner B., et al. “Sleep Homeostasis and General Anesthesia: Are Fruit Flies Well Rested after Emergence from Propofol”. Anesthesiology 2 (2016): 404-416.
  3. Leslie K., et al. “WITHDRAWN: Target-controlled infusion versus manually-controlled infusion of propofol for general anaesthesia or sedation in adults”. The Cochrane Database of Systematic Reviews 7 (2016): CD006059.
  4. Jalota L., et al. “Prevention of pain on injection of propofol: systematic review and meta-analysis”. British Medical Journal 342 (2011): d1110.
  5. Lee JY., et al. “The optimal effect-site concentration of remifentanil to attenuate the pain caused by propofol”. Korean Journal of Anesthesiology 2 (2012): 108-112.
  6. Huang CL., et al. “The effect of carrier intravenous fluid speed on the injection pain of propofol”. Anesthesia and Analgesia 5 (1995): 1087-1088.
  7. Liljeroth E., et al. “Pain on injection of propofol with or without infusion of carrier fluid”. Acta Anaesthesiologica Scandinavica7 (2001): 839-841.
  8. Gozal Y. “Lidocaine and no carrier fluid for the prevention of pain due to injection of propofol”. Anesthesia and Analgesia 5 (1996): 1111.
  9. Scott HB., et al. “The effect of remifentanil on propofol requirements to achieve loss of response to command vs. loss of response to pain”. Anaesthesia4 (2017): 479-487.
  10. Jeong M and Yoon H. “Comparison of the effects of lidocaine pre-administration and local warming of the intravenous access site on propofol injection pain: Randomized, double-blind controlled trial”. The International Journal of Nursing Studies 61 (2016): 209-218.
  11. Xing J., et al. “Intravenous Lidocaine Alleviates the Pain of Propofol Injection by Local Anesthetic and Central Analgesic Effects”. Pain Medicine 3 (2018): 598-607.
  12. Akbari H., et al. “Analgesic Effects of Ketamine, Magnesium Sulfate, and Sodium-Thiopental on Propofol Injection Pain: A Single-Blind Randomized Clinical Trial”. Tanaffos 1 (2018): 22-28.
  13. Pei S., et al. “Efficacy of ondansetron for the prevention of propofol injection pain: a meta-analysis”. Journal of Pain Research 10 (2017): 445-450.
  14. Pickford A., et al. “Propofol and pain on induction: the effect of injectate temperature in children”. Paediatr Anaesth 2 (2000): 129-132.
  15. Uda R., et al. “Strict temperature control has no effect on injection pain with propofol”. Anesthesiology 2 (1999): 591-592.
  16. Ozturk E., et al. “Temperature of propofol does not reduce the incidence of injection pain”. Anesthesiology4 (1998): 1041.
  17. Schulte B. “Temperature rising. Feeling a bit warm? You may just have to live with it”. S. News and World Report 140.21 (2006): 36-40.
  18. Nilsson AL. “Blood flow, temperature, and heat loss of skin exposed to local radiative and convective cooling”. Journal of Investigative Dermatology 5 (1987): 586-593.
  19. Joshi VS., et al. “Systemic and Local Effects of Warm Oxygen Exposure to the Lower Extremities in Healthy Volunteers”. Journal of Clinical and Diagnostic Research 4 (2017): CC01-CC03.
  20. Lee JF., et al. “Warm skin alters cardiovascular responses to cycling after preheating and precooling”. Medicine and Science in Sports and Exercise 6 (2015): 1168-1176.
  21. Ozgul U., et al. “Effect of alkalinisation of lignocaine for propofol injection pain: a prospective, randomised, double-blind study”. Anaesthesia and Intensive Care 4 (2013): 501-504.
  22. Galgon RE., et al. “Magnesium sulfate with lidocaine for preventing propofol injection pain: a randomized, double-blind, placebo-controlled trial”. The Journal of Anesthesia2 (2015): 206-211.
  23. Charkoudian N. “Skin blood flow in adult human thermoregulation: how it works, when it does not, and why”. Mayo Clinic Proceedings5 (2003): 603-612.
  24. Mencke T., et al. “Women report more pain on injection of a precurarization dose of rocuronium: a randomized, prospective, placebo-controlled trial”. Acta Anaesthesiologica Scandinavica 10 (2004): 1245-1248.
Citation: Zhiming Zhang., et al. “Chilly Feeling Verse Warm Feeling in Increasing Propofol Injection Pain in Pain-Free Bronchoscopy”. EC Emergency Medicine and Critical Care 5.6 (2021): 43-49.

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