Document Detail


Prevention of pain on injection with propofol: a quantitative systematic review.
MedLine Citation:
PMID:  10735808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The best intervention to prevent pain on injection with propofol is unknown. We conducted a systematic literature search (Medline, Embase, Cochrane Library, bibliographies, hand searching, any language, up to September 1999) for full reports of randomized comparisons of analgesic interventions with placebo to prevent that pain. We analyzed data from 6264 patients (mostly adults) of 56 reports. On average, 70% of the patients reported pain on injection. Fifteen drugs, 12 physical measurements, and combinations were tested. With IV lidocaine 40 mg, given with a tourniquet 30 to 120 s before the injection of propofol, the number of patients needed to be treated (NNT) to prevent pain in one who would have had pain had they received placebo was 1.6. The closest to this came meperidine 40 mg with tourniquet (NNT 1.9) and metoclopramide 10 mg with tourniquet (NNT 2.2). With lidocaine mixed with propofol, the best NNT was 2.4; with IV alfentanil or fentanyl, it was 3 to 4. IV lidocaine before the injection of propofol was less analgesic. Temperature had no significant effect. There was a lack of data for all other interventions to allow meaningful conclusions. The diameter of venous catheters and speed of injection had no impact on pain. Implications: IV lidocaine (0.5 mg/kg) should be given with a rubber tourniquet on the forearm, 30 to 120 s before the injection of propofol; lidocaine will prevent pain in approximately 60% of the patients treated in this manner.
Authors:
P Picard; M R Tramèr
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  90     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-04-20     Completed Date:  2000-04-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  963-9     Citation Subset:  AIM; IM    
Affiliation:
Consultation de la douleur, Service de pharmacologie clinique, CHU, Clermont-Ferrand Cedex, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesics, Opioid / therapeutic use
Humans
Injections / adverse effects*
Lidocaine / therapeutic use
Pain / prevention & control*
Propofol / administration & dosage,  adverse effects*
Randomized Controlled Trials as Topic
Temperature
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 137-58-6/Lidocaine; 2078-54-8/Propofol
Comments/Corrections
Comment In:
Anesth Analg. 2002 Apr;94(4):1040-1   [PMID:  11916821 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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