Propofol injection pain is not alleviated by pretreatment with flurbiprofen axetil, a prodrug of a nonsteroidal antiinflammatory drug

Purpose. The effects of nonsteroidal antiinflammatory drugs (NSAIDs) on pain from propofol injection are controversial, partially because NSAIDs themselves cause injection pain. We evaluated the effects of flurbiprofen axetil (LFP), a prodrug of an NSAID, on pain induced by intravenous propofol injection, because LFP produces little pain on injection. Methods. A randomized, double-blind, controlled trial was undertaken in patients who were assigned to one of three groups (n = 50 in each). Patients received either 5 ml of saline followed approximately 10 min later by propofol mixed with 0.4 ml of saline, LFP (50 mg, 5 ml) i.v. followed by propofol mixed with 0.4 ml of saline, or 5 ml of saline followed by propofol mixed with lidocaine (40 mg, 0.4 ml). Verbal rating scores for injection pain were assessed every 10s during propofol administration at a rate of 0.05 mg·kg-1·s-1. Results. None of the patients complained of pain during injection of LFP or saline. Admixture of lidocaine, but not of LFP, significantly reduced the incidence of pain and the severity of pain scores during propofol injection (P = 0.0017 and P < 0.001, respectively). Conclusion. Lidocaine, but not LFP, is effective for controlling pain induced by propofol injection. This result suggests that NSAIDs have little effect on pain from propofol injection.