FREQUENCY OF PAIN ON INJECTION AND VENOUS SEQUELAE FOLLOWING THE I.V. ADMINISTRATION OF CERTAIN ANAESTHETICS AND SEDATIVES

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Abstract
The frequency of pain on injection and the occurrence of venous sequelae were assessed following the i.v. administration of certain anaesthetic and sedative drugs. Pain on injection occurred frequently following injection in the small veins of the forearm or hand. Pain on injection was greatest with diazepam in organic solvent (Valium) (37%), infrequent with midazolam (1%) and not elicited with diazepam in soya bean oil (Diazemuls). About one in 10 patients complained of pain following thiopentone or methohexitone There was a 40% frequency of venous thrombosis, assessed on the 7-10th days after Valium This was virtually absent with Diazemuls and midazolam. A 10% frequency was found following 1% methohexitone and disoprofol (ICI35 868). We suggest that the injection of Valium should be avoided except in large antecubital veins, although even here the complication rate is higher than with Diazemuls.