Prevention of Propofol Injection Pain: A Comparison of Lidocaine Pretreatment and Lidocaine Pretreatment with the Diluted Propofol with Dextrose Water
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Abstract
Introduction: Pain on propofol injection is commonly
found. The intensity of pain relates to the concentration of
free propofol.
Objective: We aimed to assess the effect of diluted
propofol combined with lidocaine pretreatment on injection
pain.
Methods: A prospective randomized controlled trial was
conducted in patients scheduled for elective procedures
under general anesthesia. The patients were allocated into
2 groups, the lidocaine pretreatment with diluted propofol
(D) group and the lidocaine pretreatment with undiluted
propofol (P) group. Lidocaine 40 mg was administered
before the injection of propofol in both groups. In the
D group, 1% propofol 30 mg was diluted with dextrose
water into 0.5 % propofol before injection. In the P group,
30 mg of 1% propofol was injected. The severity of pain
was evaluated by asking and observing behavioral responses. The primary outcome was the incidence of
pain. The intensity of pain and adverse events were
recorded as secondary outcomes.
Results: We randomly allocated 328 patients to either D
group (n=164) or P group (n=164). The incidence of pain
in the D and P group was not different (42.1% and 44.5%,
respectively; p 0.656). The reported mild, moderate, and
severe pain was 34.1, 6.1, and 1.9% in the D group, and
36.6, 4.9, and 3% in the P group. There were no
bradycardia and hypotension in both groups.
Conclusions: The dilution of medium chain and long chain
triglyceride emulsive propofol with dextrose water did not
potentiate the effect of lidocaine in reducing pain on
injection of propofol.
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