Document Detail

Avoiding propofol injection pain in children: a prospective, randomized, double-blinded, placebo-controlled study.
MedLine Citation:
PMID:  18567678     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pain on injection limits the use of propofol in children. The combination of lidocaine and propofol is widely used to reduce pain. A new solvent [medium-chain triglyceride (mct)/long-chain triglyceride (lct)] has been advocated to be less painful than standard (lct) propofol in adults, but no information is available of its usefulness in pre-school children. We designed a prospective, randomized, double-blinded, placebo-controlled study to assess injection pain with two different propofol emulsions, each given with or without lidocaine in children <7 yr. METHODS: A total of 160 ASA I-III children were randomly assigned to receive lct-propofol or mct/lct-propofol, 5 mg kg(-1), with lidocaine 10 mg ml(-1) or saline. The site and size of venous cannulation and restlessness before injection were recorded in each patient. A pain score graded 0-6 was established based on spontaneous verbal and motor reaction during injection, each graded 0-3. Kruskall-Wallis and Mann-Whitney tests were used for statistical analysis. RESULTS: Median pain scores decreased in all groups compared with lct-propofol-saline (P<0.001) and were least in the lct/mct-propofol-lidocaine group (P<0.001). Painless injection (score, 0-2) occurred in 92.5% of patients in the mct/lct-propofol-lidocaine group compared with 41-77% in the others (P<0.001). CONCLUSIONS: Mct/lct-propofol caused significantly less pain than lct-propofol in preschool children. Mixing of lidocaine with mct/lct-propofol resulted in a further significant decrease, virtually eliminating the pain on injection.
A Rochette; A F Hocquet; C Dadure; D Boufroukh; O Raux; J F Lubrano; S Bringuier; X Capdevila
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2008-06-20
Journal Detail:
Title:  British journal of anaesthesia     Volume:  101     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-19     Completed Date:  2008-09-05     Revised Date:  2008-12-03    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  390-4     Citation Subset:  IM    
Department of Anaesthesia and Intensive Care A, Hôpital Lapeyronie, Montpellier, France.
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MeSH Terms
Anesthetics, Intravenous / administration & dosage,  adverse effects*
Anesthetics, Local
Chemistry, Pharmaceutical
Child, Preschool
Double-Blind Method
Injections, Intravenous / adverse effects
Pain / etiology,  prevention & control*
Pain Measurement / methods
Propofol / administration & dosage,  adverse effects*
Prospective Studies
Reg. No./Substance:
0/Anesthetics, Intravenous; 0/Anesthetics, Local; 0/Solvents; 0/Vehicles; 137-58-6/Lidocaine; 2078-54-8/Propofol
Comment In:
Br J Anaesth. 2008 Dec;101(6):878-9; author reply 879   [PMID:  19004917 ]
Br J Anaesth. 2008 Dec;101(6):879; author reply 879   [PMID:  19018611 ]

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