Comparison of large antecubital vein versus small vein on dorsum of hand for prevention of propofol injection pain.

Abstract

Objective: To determine whether using a large antecubital vein versus a small dorsum hand vein reduces the incidence and severity of pain during propofol injection in pediatric patients. Study Design: Non Randomized Controlled Trial. Setting: Institute of Child Health, Faisalabad. Period: 01 January 2025 to 30 April 2025. Methods: This study included 214 children aged 8–14 years undergoing elective surgery under general anesthesia. Participants were assigned to two groups: Group 1 received a propofol-lidocaine mixture via a large antecubital vein, and Group 2 via a small vein on the dorsum of the hand. Pain during injection was assessed using a Visual Analogue Scale (VAS) from 0 to 10, and categorized as none, mild, moderate, or severe. Baseline and post-injection heart rate, blood pressure, and oxygen saturation were recorded. Results: Group 1 (antecubital vein) reported significantly lower pain scores compared to Group 2. Forty-seven (43.9%) patients in Group 1 reported no pain, versus 13 (12.1%) in Group 2. Severe pain was reported in only 10.3% of Group 1 compared to 31.8% of Group 2. The average pain score was 2.63 ± 1.80 in Group 1 and 5.95 ± 2.79 in Group 2 (p < 0.001). Conclusion: Administering propofol-lidocaine admixture through a large antecubital vein significantly reduces injection pain compared to a small dorsum hand vein in children. This simple technique should be considered to enhance patient comfort during anesthesia induction.