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Deep breathing alleviates propofol-induced pain: a prospective, randomized, single-blind study

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Abstract

Purpose

Propofol is commonly used to induce general anesthesia; however, the pain caused during propofol injection is a disadvantage. This study aimed to assess whether deep breathing attenuates propofol injection pain.

Methods

This prospective, single-blind, randomized controlled study included 200 patients who were scheduled to undergo elective surgery under general anesthesia and randomly and equally divided them into group D and group C. The observers were not blinded to the pain-relieving modality, but each patient was blinded. Group D patients were requested to repeatedly take deep breaths throughout general anesthesia induction with propofol. Group C patients were requested to breathe in the usual manner. The intensity of propofol injection pain was evaluated using the visual analog scale (VAS). Furthermore, we recorded the patients’ pain expressions, including grimace or hand-withdrawal, and the recalled pain measured using a VAS in the post-anesthetic care units (PACU).

Results

Compared with patients in group C, those in group D showed significantly reduced VAS scores for propofol injection pain (20 [interquartile range (IQR): 0–48] vs. 37 [IQR 9–65], P = 0.017) and recalled pain in the PACU (16 [IQR 0–32] vs. 26 [IQR 0.5–51], P = 0.031). Further, the grimace incidence was significantly lower in group D (18%) than in group C (45%) (P < 0.001). There was no significant difference in the incidence of pain at induction, recalled pain, or hand-withdrawal.

Conclusions

Deep breathing could be an easy, safe, and inexpensive method for reducing pain during propofol injection.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abeno-Ku, Osaka City, Osaka, 545-8586, Japan

    Katsuaki Tanaka & Takashi Mori

  2. Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan

    Yuko Yoshizumi

  3. Department of Anesthesiology, Japan Community Healthcare Organization Osaka Hospital, 4-2-78 Fukushima, Fukushima-Ku, Osaka City, Osaka, 553-0003, Japan

    Taku Hamada

  4. Department of Anesthesiology, Shiraniwa Hospital, 6-10-1 Shiraniwadai Ikoma City, Nara, 630-0136, Japan

    Kiyonobu Nishikawa

Authors
  1. Katsuaki Tanaka
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  2. Yuko Yoshizumi
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  4. Kiyonobu Nishikawa
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  5. Takashi Mori
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Contributions

KT: methodology, validation, formal analysis, data curation, writing—original draft, project administration. YY: conceptualization, data curation, visualization, writing—review and editing. TH: investigation, data curation, visualization, writing—review and editing. KN: validation, writing—review and editing, supervision. TM: validation, writing—review and editing, supervision. All authors were involved in the study design and data interpretation. All authors revised the manuscript, approved the manuscript for publication, and agree to be accountable for all aspects of the work in ensuring that the questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Katsuaki Tanaka.

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Tanaka, K., Yoshizumi, Y., Hamada, T. et al. Deep breathing alleviates propofol-induced pain: a prospective, randomized, single-blind study. J Anesth 37, 97–103 (2023). https://doi.org/10.1007/s00540-022-03136-6

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  • DOI: https://doi.org/10.1007/s00540-022-03136-6

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