Medium-/long-chain triglyceride emulsion reduced severity of pain during propofol injection

The Effect of Propofol Infusion Before Administration of Its Bolus Dose on Propofol Injection Pain and Serum Complement C3 Levels; A Randomized Clinical Trial

Background

Pain on injection with propofol is still a major problem associated with anesthesia. Several factors involved in this event have been studied with respect to their pain attenuating effects.

Objectives

The purpose of this study was to evaluate the effect of propofol infusion before administration of its bolus dose of propofol on the resulted pain at its induction dose and on serum complement C3 levels.

Methods

This clinical trial was performed on patients undergoing surgery under general anesthesia divided into three groups, including A (without intervention), B (propofol infusion at a dose of 50 µg/kg/min before anesthesia induction), and C (propofol infusion at a dose of 100 µg/kg/min 100 before anesthesia induction). During anesthesia induction by propofol, the presence, absence or severity of pain was determined using the Numerical Rating Pain Scale. Serum complement C3 levels were measured and their relationships with pain scores were compared between three groups. The data were analyzed using SPSS V. 22 software.

Results

There were significant differences in the mean pain scores between three groups (P < 0.05). However, no significant difference in the mean pain scores was observed between the groups B and C (P > 0.05). The mean and standard deviation of the differences in complement C3 values in the three groups before and after injection were 72.15 ± 14.9, 27.65 ± 9.82, and 18.95 ± 4.68, respectively, which demonstrated a significant difference between three groups (P < 0.05). However, the difference in complement C3 values between the groups B and C was not significant (P > 0.05).

Conclusions

According to the obtained results, the low doses of infused propofol, 2 minutes before administration of its bolus dose, seems to have a considerable attenuating effect on its pain score.

The composition of oil phase modulates venous irritation of lipid emulsion-loaded diallyl trisulfide

INTRODUCTION

In this study, a nanoemulsion system (LE) was investigated for intravenous delivery of diallyl trisulfide (DT), which was a lipophilic and venous irritant drug for systemic therapy of bacterial and fungal infection.

METHODS

Egg phospholipid was chosen as the only emulsifier, soybean oil, medium chain triglyceride (MCT), and olive oil were used as the oil phases, forming stable DT LEs (o/w) with small particle sizes. The venous irritation of DT LEs was evaluated by in vitro human umbilical cord endothelial cells (HUV-EC CRL 1730) tolerance model with the intracellular ATP and GTP concentrations as the indices.

RESULTS

The intracellular ATP and GTP reduction changed with the incorporation of a variety of oils, which were strongly related with the free DT concentration of DT LEs.

DISCUSSION

It was deduced that the free DT concentrations of LEs made of various oils depended on the particle sizes of the DT LEs. In conclusion, the oil phases modulated the free DT concentrations by forming DT LEs with different particle sizes, and optimization of the oil phase was an effective method to alleviate the venous irritation of DT LEs.