BACKGROUND: Propofol injections can cause discomfort for various reasons, and the onset of this discomfort can be either sudden or delayed. Several interventions are being explored to reduce the pain associated with propofol administration. Against this backdrop, we compared the severity of pain during propofol injection in patients preadministered with either 6% hydroxyethyl starch (HES) 130/0.4 or 2% lidocaine during the induction of anesthesia. MATERIALS AND METHODS: A comparative and observational study was conducted among 70 patients (35 in each group) undergoing elective surgery under general anesthesia. Adult patients classified as American Society of Anesthesiologists 1 and 2, aged 18-55 years, of either gender, were included. A comprehensive preanesthetic assessment was carried out. Hemodynamic variables, incidence and severity of pain, and side effects were assessed. Data analysis was performed using the SPSS version 17. RESULTS: At 10-s postoperative period, 14.3% of participants in the HES group experienced pain, while only 2.9% of participants in the lidocaine group reported pain. At 20 s, 14.3% of participants in the HES group experienced pain, compared to 2.9% in the lidocaine group. In the HES group, 91.4% experienced no pain before losing verbal contact, whereas 97.1% in the lidocaine group reported no pain. The incidence of pain was higher in females than males at all time points (P <
0.05). CONCLUSION: In our observational study, both HES and lidocaine demonstrated hemodynamic stability, supporting their safe use as premedication agents. However, the differences in pain incidence suggest that lidocaine may offer advantages in certain scenarios.