Comparison of the effectiveness of tourniquet and Valsalva maneuver in relieving pain caused by propofol injection to induce general anesthesia: A double-blind randomized clinical trial

Introduction: Propofol is one of the most common anesthetic drugs. Painful injection with a reported prevalence of 28 to 90% in various studies is one of the problems of taking Propofol. The present study investigated the effect of performing the Valsalva maneuver and tourniquet twisting on pain intensity and hemodynamic changes.
Materials and Methods: This clinical trial was performed on 105 patients under general anesthesia with propofol that was randomly divided into three groups Valsalva, tourniquet, and control. Pain caused by propofol injection was evaluated using the withdrawal response score from 0 (painless) to 3. Hemodynamic parameters including blood pressure (systolic, diastolic, mean arterial), heart rate, and oxygen saturation level have been measured too.
Results: Statistical analysis showed that there was no significant relationship between the distribution of pain intensity among the three groups, however the frequency of people with moderate pain intensity and painless in the tourniquet and Valsalva groups increased significantly compared to the control group. There was also a significant correlation between blood pressure systolic, diastolic, mean arterial (P=0.0001), and heart rate (P=0.013) in the three groups, and no significant difference was observed between oxygen saturation levels in the three groups (P=0.102). Mean blood pressure in the Valsalva group and heart rate in the tourniquet group is higher than in other groups.
Conclusion: Valsalva maneuvering and tourniquet twisting reduce the pain caused by propofol injection, with the difference that the mean blood pressure in the Valsalva group is greater than that in the tourniquet group