Evaluation of the efficacy of the valsalva maneuver and fentanyl administration for attenuating etomidate injection pain: A double-blind clinical trial

Objective: Etomidate is mentioned as one of the rapid intravenous anesthetic drugs whose unique characteristics include hemodynamic stability, negligible respiratory depression, and brain protection. The most common complication of etomidate is intravenous pain during injection. The purpose of this study was to compare the effectiveness of the Valsalva maneuver and fentanyl in reducing the pain caused by etomidate injection for anesthesia induction.Methods: This clinical trial was performed on ۹۶ patients at Alzahra hospital, affiliated with the Isfahan University of Medical Sciences, from January to June ۲۰۲۱. Patients were divided into two groups of ۴۸ people: the Valsalva maneuver group (group ۱) and the fentanyl group (group ۲). Blood pressure, heart rate (HR), oxygen saturation, and pain of etomidate injection using the withdrawal response score were graded on a four-point scale (no pain = zero, mild pain = ۱, average pain = ۲, and severe pain = ۳). The collected information was entered into SPSS software version ۲۴. Then, the pain score in the two groups was compared using the chi-square test. The significance level in the present study was P < ۰.۰۵.Results: The mean HR (P = ۰.۰۷), mean arterial pressure (MAP) (P = ۰.۳۳), systolic pressure (P = ۰.۹۰), diastolic pressure (P = ۰.۶۷), and oxygen saturation level (P = ۰.۲۷) at different times between the two groups showed no significant difference (P > ۰.۰۵). However, during the etomidate injection, the HR increased and after the injection, the HR decreased in both groups (P = ۰.۰۴۲). The two groups had no significant difference regarding pain frequency.Conclusion: There was no difference in the effect of the Valsalva maneuver and fentanyl on reducing the pain caused by etomidate injection.

Keywords:

Valsalva maneuver , Etomidate , Fentanyl , Pain