+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Pain on injection of propofol: propofol LCT vs propofol MCT/LCT with or without lidocaine pretreatment



Pain on injection of propofol: propofol LCT vs propofol MCT/LCT with or without lidocaine pretreatment



Journal of the Medical Association of Thailand 89(Suppl. 3): S86



Pain on injection was a disadvantage of propofol long-chain triglyceride (LCT) and reduces patient satisfaction. Based on a systematic review, the recommended method to attenuate this pain was a previous administration of lidocaine under tourniquet for 30-120 seconds before injection of propofol (pretreatment of lidocaine). Recently, propofol medium-chain triglyceride/long-chain triglyceride (MCT/LCT) emulsion was proposed for its ability to decrease pain on injection. The authors conducted a double-blind randomized controlled trial to compare the incidence and severity of pain on injection between the new propofol MCT/LCT and the propofol LCT with and without lidocaine pretreatment. 360 adult patients with ASA physical status I-III who underwent general anesthesia were assigned into 4 groups by computer-generated randomization; Group I - pretreatment of lidocaine 1% and propofol LCT Group I - pretreatment oflidocaine 1% and propofol MCT/LCT Group III - pretreatment of saline and propofol MCT/LCT and Group IV- pretreatment of saline and propofol LCT mixed with lidocaine 1%. All groups received pretreatment under tourniquet for 60 seconds. Evaluators who were blinded to the injected drugs recorded pain intensity (none, mild, moderate and severe) after the first 30% of total induction dose ofpropofol was injected at a rate of 1 ml/s by questioning patients. Data was analyzed by using Kruskal-Wallis testfor ordinal data. Post hoc analysis was performed by using the Mann-Whitney U-test with Bonferroni's correction on pairwise comparisons and was considered significant with p value of less than 0.05. Patients in an individual group had insignificant differences in their demographic data. The incidences of pain in Group I, II, III and IV were 61.1%, 46.7%, 62.2% and 55.6% respectively with an average incidence of 56% (p = 0.006). There were 15.6%, 5.6%, 23.3% and 24.4% of patients in Group I, II, III and IV who rated pain intensity as severe. Pain on injection of propofol MCT/LCT with lidocaine pretreatment was less than propofol MCT/LCT alone (p = 0.001). The incidence of pain on injection of propofol MCT/LCT was not different from that caused by propofol LCT with pretreatment of lidocaine and the intensity of pain on propofol MCT/LCT injection decreased significantly when using lidocaine pretreatment. Therefore, the authors could conclude that an injection of new propofol MCT/LCT solution was an alternative in reducing pain sensation to propofol LCT with pretreatment of lidocaine. Additionally, pain of propofol MCT/LCT injection could be alleviated by pretreatment of lidocaine with a 60 seconds tourniquet time before the injection ofpropofol.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 054847121

Download citation: RISBibTeXText

PMID: 17722306


Related references

Lidocaine pretreatment with tourniquet versus lidocaine-propofol admixture for attenuating propofol injection pain: a randomized controlled trial. Regional Anesthesia and Pain Medicine 36(1): 41-45, 2011

Reduction of pain on injection of propofol: combination of pretreatment of remifentanil and premixture of lidocaine with propofol. European Journal of Anaesthesiology 24(9): 746-750, 2007

Prevention of propofol injection pain in children: a comparison of pretreatment with tramadol and propofol-lidocaine mixture. International Journal of Medical Sciences 9(6): 492-497, 2012

Propofol-induced injection pain: comparison of a modified propofol emulsion and standard propofol with premixed lidocaine. Anesthesia and Analgesia 100(6): 1858; Author Reply 1858-9, 2005

Propofol-induced injection pain: comparison of a modified propofol emulsion to standard propofol with premixed lidocaine. Anesthesia and Analgesia 99(4): 1076, 2004

Propofol injection pain in children: a prospective randomized double-blind trial of a new propofol formulation versus propofol with added lidocaine. British Journal of Anaesthesia 95(2): 222-225, 2005

Comparison of Propofol-Lipuro with propofol mixed with lidocaine 10 mg on propofol injection pain. Anaesthesia 59(12): 1167-1169, 2004

Pain on injection: a double-blind comparison of propofol with lidocaine pretreatment versus propofol formulated with long- and medium-chain triglycerides. Anesthesia and Analgesia 99(6): 1699-702, 2004

Comparison of effect of premixed lidocaine in propofol with or without ketorolac pretreatment with placebo on reducing pain on injection of propofol: A prospective, randomized, double-blind, placebo-controlled study in adult Korean surgical patients. Current Therapeutic Research Clinical and Experimental 70(5): 351-358, 2009

Effect of pre-mixed lidocaine with propofol on propofol injection pain in elderly patients. Masui. Japanese Journal of Anesthesiology 49(11): 1235-1238, 2000

Injection pain secondary to propofol-MCT/LCT and propofol-LCT--comparison of prophylaxis with lidocaine. Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie 38(10): 643-647, 2003

Propofol-LCT versus propofol-MCT/LCT with or without lidocaine - a comparison on pain on injection. Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie 39(1): 10-14, 2004

Comparison on pain on injection of a small particle size-lipid emulsion of propofol and standard propofol with or without lidocaine. Journal of the Medical Association of Thailand 88(10): 1401-1405, 2005

Efficacy of the combination of cold propofol and pretreatment with remifentail on propofol injection pain. Korean Journal of Anesthesiology 59(5): 305-309, 2010

Efficacy of simultaneous bolus injection of lidocaine with propofol on pain caused by propofol injection. Masui. Japanese Journal of Anesthesiology 50(11): 1196-1200, 2001