Skin cooling and topical application of menthol can reduce propofol injection-induced pain, a randomized trial

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BACKGROUND: Skin cooling has an analgesic effect on propofol injection-induced pain. We evaluated the analgesic effectiveness of topical menthol application and skin cooling for reducing propofol injection-induced pain. METHODS: Patients (n = 120) were randomized to a cooling group, a room temperature group (non-cooling group), a menthol group, and a solvent group. In the cooling group, a cooling gel pad (7°C) was applied to the forearm. In the non-cooling group, a gel pad (25°C) was used. In the menthol group, 30% menthol was applied to the forearm. In the solvent group, a solvent was applied. Fifteen minutes after these interventions, propofol was intravenously injected. We assessed the incidence and severity of propofol injection-induced pain. RESULTS: The incidence of propofol injection-induced pain in the cooling group was significantly lower than that in the non-cooling group (27% vs 52%, P = .049). The pain intensity in the cooling group was lower than that in the non-cooling group (P = .027). The incidence of propofol injection-induced pain in the menthol group was significantly lower than that in the solvent group (13% vs 40%, P = .020). The pain intensity in the menthol group was lower than that in the solvent group (P = .021). CONCLUSION: Topical menthol application and skin cooling are effective for reducing propofol injection-induced pain.

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