Is propofol injection pain really important to patients?

Wen Wang, Linxin Wu, Chaobin Zhang, Li Sun

Propofol injection pain (PIP) has been adequately studied during the past decades. However, patients' opinion on this problem and the incidence of patients' recall of this brief discomfort are still unknown. Thus, we conducted this study to know the patients' perspectives on PIP and provide useful information about the incidence of recall of PIP under our routine general anesthesia. Five hundred preoperative questionnaires were distributed to patients who were scheduled for elective open thyroidectomy under general anesthesia from May 2016 to July 2016. They were asked to rank ten possible adverse effects associated with general anesthesia from their most undesirable to their least undesirable effect. Patients who completed the preoperative questionnaires were asked whether they could recall PIP and to grade the severity of PIP on the first postoperative day. A total of 448 preoperative questionnaires were returned and analyzed with an efficient rate of 89.6%. Incisional pain was ranked as most undesirable, followed (in order) by vomiting, gagging on the tracheal tube, nausea, sore throat, propofol injection pain, shivering, intravenous puncture pain, and anxiety. The majority (91.5%) of surveyed patients could not recall any discomfort or pain during anesthetics injection. Of those who could recall PIP, 89.5% grade it as mild pain, 7.9% moderate pain, and 2.6% severe pain. Most of patients undergoing elective open thyroidectomy in our hospital viewed PIP as a relatively minor problem. The incidence of recall of PIP was low and the majority of those who recalled regarded it as mild, temporary and acceptable pain. However, further investigations into propofol injection pain may be warranted as patients' perspectives on propofol injection pain and its severity may differ between patient populations.