{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:20:57Z","timestamp":1769559657810,"version":"3.49.0"},"reference-count":18,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,1,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Propofol, a commonly used intravenous anesthetic induction agent, frequently produces pain on injection, with an incidence ranging from 28% to 91%. This study aimed to compare the effect of low-dose ketamine and a pressure vibration mechanical device with placebo in reducing pain during propofol injection in patients undergoing elective surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this randomized, double-blind, placebo-controlled trial, 300 adults were allocated to pressure vibration (Group V), low-dose ketamine (Group K), or saline placebo (Group P); 275 patients completed the study and were analyzed (92, 91, and 92 patients, respectively). Group P received 5\u2009mL 0.9% saline, Group K ketamine 50\u2009\u00b5g\/kg diluted in 5\u2009mL saline, and Group V saline with an activated pressure vibration device applied proximal to the intravenous cannula, each administered over 1\u2009min. Propofol 2\u2009mg\/kg was infused, with the first 25% delivered at 600\u2009mL\/hour, and pain assessed using the McCrirrick and Hunter verbal rating score. The primary outcome was pain on propofol injection. Continuous variables were analyzed using one-way analysis of variance or Kruskal-Wallis tests, categorical variables with \u03c7\u00b2 tests, with Bonferroni correction applied for multiple primary outcome comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 275 analyzed patients, the incidence of no pain was highest in the pressure vibration device group 51.1%; 95%\u2009CI 42.4% to 59.8% compared with placebo 30.4%; 95%\u2009CI 21.0% to 39.8% and ketamine 33.0%; 95%\u2009CI 23.3% to 42.6%; (p=0.001). Severe pain was more frequent in the placebo group (18.5%; 95%\u2009CI 10.5% to 26.4%) than in the ketamine (5.5%; 95%\u2009CI 0.8% to 10.2%) and vibration groups (4.3%; 95%\u2009CI 0.2% to 8.5%; (p=0.001). Recall of injection pain at 1\u2009week was significantly higher with placebo compared with ketamine and vibration device (55.4%, 37.4%, and 26.1%, respectively; p&lt;0.001). Hemodynamic variables and adverse events were comparable across groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The pressure vibration mechanical device significantly reduced the incidence and severity of propofol injection pain compared with placebo and was at least as effective as low-dose ketamine. Pain recall at 1\u2009week was higher with placebo. This device provides an effective, reusable, non-pharmacological alternative without drug-related adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>CTRI\/2022\/12\/048300.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2025-107399","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T11:05:12Z","timestamp":1769511912000},"page":"rapm-2025-107399","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing the effect of low-dose ketamine and pressure vibration mechanical device with placebo in preventing pain on propofol injection in a patient undergoing elective surgery: a double-blind, randomized control study"],"prefix":"10.1136","author":[{"given":"Shreem","family":"Rawal","sequence":"first","affiliation":[{"name":"Anaesthesia & Critical Care, Institute of Liver and Biliary Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9161-7000","authenticated-orcid":false,"given":"Neeraj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences Patna, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9247-6713","authenticated-orcid":false,"given":"Abhyuday","family":"Kumar","sequence":"additional","affiliation":[{"name":"Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences Patna, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunal","family":"Singh","sequence":"additional","affiliation":[{"name":"Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences Patna, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajeet","family":"Kumar","sequence":"additional","affiliation":[{"name":"Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences Patna, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alok","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Community and Family Medicine, AIIMS Patna, Patna, Bihar, 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