A COMPARISON OF DEXAMETHASONE AND METOCLOPRAMIDE FOR PREVENTING PAIN ON INJECTION OF DIAZEPAM

Intravenous administration of dexamethasone before diazepam injection seems to reduce the incidence of pain on injection. We conducted a randomized, prospective, double-blind, placebo-controlled clinical trial to compare effect of dexamethasone, metoclopramide and placebo in reducing the injection pain. A total of 120 ASA class I and II men aged 20-45 years that needed more than one intravenous access were enrolled in the study and were randomly allocated to one of the three groups: group 1, 2 ml intravenous normal saline and 2 ml dexamethasone (8 mg); group 2, 2 ml intravenous normal saline and 2 ml metoclopramide (10 mg), and group 3, 2 ml intravenous dexamethasone (8 mg) and 2 ml metoclopramide (10 mg). After 30 seconds, 1 ml diazepam (5 mg) was injected simultaneously into each of patients hand veins and a maximal visual analog scale (VAS) for pain of each venous discomfort was assessed separately. In group 1, the mean of VAS for pain was significantly less in dexamethasone pretreatment than saline pretreatment. In group 2, the mean of VAS for pain was significantly less in metoclopramide pretreatment than saline pretreatment. In group 3, the mean of VAS for pain was significantly less in dexamethasone pretreatment than metoclopramide pretreatment. There were no significant differences in incidence of pain between pretreatment and placebo in three groups. Dexamethasone or metoclopramide pretreatments are effective in reducing the severity of pain on injection of diazepam and dexamethasone pretreatment has greater efficacy in reducing the intensity of pain