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Preventing pain during injection of propofol: effects of a new emulsion with lidocaine addition

Published online by Cambridge University Press:  07 July 2006

B. Bachmann-Mennenga ,
A. Ohlmer ,
R. Hasso Boedeker ,
M. Mann ,
B. Mühlenbruch  and
M. Heesen
B. Bachmann-Mennenga
Affiliation:
Klinikum Minden, Department of Anaesthesiology, Minden, Germany
A. Ohlmer
Affiliation:
Klinikum Minden, Department of Anaesthesiology, Minden, Germany
R. Hasso Boedeker
Affiliation:
University of Giessen, Department of Biometrics, Giessen, Germany
M. Mann
Affiliation:
University of Giessen, Department of Biometrics, Giessen, Germany
B. Mühlenbruch
Affiliation:
Klinikum Minden, Department of Anaesthesiology, Minden, Germany
M. Heesen
Affiliation:
Klinikum Bamberg, Department of Anaesthesiology, Bamberg, Germany
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Summary

Background and objective: Previous studies found that lidocaine addition to propofol long-chain triglyceride was associated with a lower incidence of injection pain than medium-chain triglyceride/long-chain triglyceride formulation, but the incidence was still high (31–40%). Our study investigated whether the incidence of injection pain could be further reduced by the addition of lidocaine (10 mg, 20: 1) to propofol medium-chain triglyceride/long-chain triglyceride. Methods: In a randomized double-blind controlled trial 464 patients scheduled to undergo regional anaesthesia were assigned to receive one of the following four options: propofol medium-chain triglyceride/long-chain triglyceride + lidocaine, propofol long-chain triglyceride +lidocaine, propofol medium-chain triglyceride/long-chain triglyceride or propofol long-chain triglyceride. Propofol was injected to reach grade 3 of the Observer’s Assessment of Alertness/Sedation scale. Results: Incidence of injection pain was 18% in the propofol medium-chain triglyceride/long-chain triglyceride +lidocaine group, 31% in the propofol long-chain triglyceride +lidocaine group, 47% in the propofol medium-chain triglyceride/long-chain triglyceride group and 60% in the long-chain triglyceride group. Propofol medium-chain triglyceride/long-chain triglyceride + lidocaine was associated with a statistically significant reduced incidence of injection pain compared with propofol long-chain triglyceride +lidocaine ( P =0.0249, number needed to treat =7.7). Conclusions: Premixing propofol medium-chain triglyceride/long-chain triglyceride with lidocaine is one of the most effective measures currently available to reduce the incidence of injection pain in sedated patients during regional anaesthesia.

Keywords

ANAESTHETICS, INTRAVENOUS, propofolPAIN ACUTE AND POSTOPERATIVELOCAL ANAESTHETIC AGENTS, lidocaineDRUG FORMULATION
Type
Origina Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 1 , January 2007 , pp. 33 - 38
Copyright
© 2006 European Society of Anaesthesiology

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