Comparison of the effectiveness of tourniquet and Valsalva maneuver inrelieving pain caused by Propofol injection to induce general anesthesia :ADouble-Blind Randomized Clinical Trial

Background: Propofol is one of the most common anesthetic drugs. Painful injection with a reported prevalenceof ۲۸ to ۹۰% in various studies is one of the problems of taking Propofol. The present study investigated theeffect of performing Valsalva maneuver and tourniquet twisting on pain intensity and hemodynamic changes.Materials and Methods: This clinical trial was performed on ۱۰۵ patients under general anesthesia with propofolthat was randomly divided into three groups of Valsalva, tourniquet, and control. Pain caused by propofolinjection was evaluated using the withdrawal response score from ۰ (painless) to ۳. Hemodynamic parametersincluding blood pressure (systolic, diastolic, mean arterial), heart rate, and oxygen saturation level have beenmeasured too.Results: Statistical analysis showed that there was no significant relationship between the distribution of painintensity among the three groups, however the frequency of people with moderate pain intensity and painless inthe tourniquet and Valsalva groups increased significantly compared to the control group. There was also asignificant correlation between blood pressure systolic, diastolic, mean arterial (p=۰.۰۰۰۱), and heart rate(p=۰.۰۱۳) in the three groups and no significant difference was observed between oxygen saturation levels inthe three groups (p=۰.۱۰۲). Mean blood pressure in the Valsalva group and heart rate in the tourniquet group ishigher than in other groups.Conclusion: Valsalva maneuvering and tourniquet twisting reduce the pain caused by propofol injection, with thedifference that the mean blood pressure in the Valsalva group is greater than that in the tourniquet group.