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Dexamethasone Dose Attenuates Pain on Injection Following Diazepam Hydrochloride

Movafegh, Ali MD; Gharehdaghi, Farid Abolhasan MD; Khan, Zahid Hussain MD; Shoeibi, Gita MD

doi: 10.1213/01.ANE.0000151567.76745.A6
Letters to the Editor: Letters & Announcements

Department of Anesthesiology and Critical Care; Dr. Ali Shariati Hospital; Tehran University of Medical Sciences; Tehran, Iran; Movafegh@sina.tums.ac.ir; ali@movafegh.com

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To the Editor:

To test the hypothesis of whether a prior injection of dexamethasone attenuated or abolished pain following diazepam injection, we conducted a randomized, prospective, double-blind, placebo-controlled clinical trial to compare dexamethasone, metoclopramide, and normal saline in 120 ASA class I and II men aged 20–45 years. The subjects were randomly allocated into one of the three groups:

  • Group 1: 2 mL IV normal saline in one hand and 2 mL dexamethasone in the other, simultaneously.
  • Group 2: 2 mL IV normal saline into one hand and 2 mL metoclopramide in the other, simultaneously.
  • Group 3: 2 mL IV metoclopramide in one hand and 2 mL dexamethasone in the other, simultaneously.

After 30 seconds, diazepam hydrochloride was injected simultaneously into each of patients' hand veins, and maximal Verbal Analog Scale (VAS) was assessed for discomfort. In Group 1, the mean of VAS for pain was significantly less in dexamethasone than saline pretreatment (P < 0.001), whereas in Group 2, metoclopramide pretreatment had significantly more effect than saline in reducing pain (P < 0.001). In Group 3, the pain observed on above scale was significantly less in dexamethasone than metoclopramide. In conclusion, although both dexamethasone and metoclopramide proved effective in reducing the severity of pain following diazepam, the former proved to be more efficacious. Efficacy of metoclopramide in reducing pain on injection following diazepam is clear (1).

Ali Movafegh, MD

Farid Abolhasan Gharehdaghi, MD

Zahid Hussain Khan, MD

Gita Shoeibi, MD

Department of Anesthesiology and Critical Care; Dr. Ali Shariati Hospital; Tehran University of Medical Sciences; Tehran, Iran; Movafegh@sina.tums.ac.ir; ali@movafegh.com

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Reference

1. Majedi H, Rabiee M, Hussain Khan Z, Hassannasab B. A comparison of metoclopramide and lidocaine for preventing pain on injection on diazepam. Anesth Analg 2002;95:1297–9.
© 2005 International Anesthesia Research Society