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Lidocaine is more efficient than the choice of propofol formulations to reduce incidence of pain on induction

Published online by Cambridge University Press:  01 May 2007

A. Mallick ,
S. C. Elliot ,
K. Krishnan  and
M. Vucevic
A. Mallick*
Affiliation:
Anaesthesia and Intensive Care Unit, Leeds, UK
S. C. Elliot
Affiliation:
Adult General Intensive Care Unit, Leeds, UK
K. Krishnan
Affiliation:
Anaesthesia, Leeds General Infirmary, Leeds, UK
M. Vucevic
Affiliation:
Anaesthesia, Leeds General Infirmary, Leeds, UK
*
Correspondence to: Abhiram Mallick, Anaesthesia and Intensive Care Unit, Leeds General Infirmary, Leeds LS1 3EX, UK. E-mail: abhiram.mallick@leedsth.mhs.uk; Tel: +44 1133926345; Fax: +44 1133928431
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Summary

Background and objective

Propofol is associated with pain on injection. It is common practice to premix lidocaine with propofol prior to injection. Lipuro propofol, a propofol emulsified in medium- and long-chain triglycerides, has been shown to reduce the intensity of injection pain compared to Diprivan®, although a number of studies report no reduction in overall incidence of pain.

Methods

We conducted this randomized double-blind trial to determine the extent of further pain reduction by adding lidocaine to Lipuro propofol. A total of 328 ASA I–III patients were randomized to one of four groups to receive Diprivan propofol (Group DP), Lipuro propofol (Group LP), Diprivan with lidocaine (Group DL) and Lipuro propofol with lidocaine (Group LL). The drug mixture was administered at a constant rate of 400 mL h−1 via a 20-G cannula into a dorsal hand vein. Pain was assessed during induction and upon patient recovery, using a 10-point visual analogue scale.

Results

Both the incidence and severity of pain were found to be significantly lower with addition of lidocaine to Lipuro propofol (P < 0.0002) compared to Lipuro alone, Diprivan with or without the addition of lidocaine.

Conclusion

Lidocaine added to Lipuro propofol makes induction of anaesthesia less painful compared to Lipuro propofol alone or Diprivan with lidocaine.

Keywords

ANAESTHETICSINTRAVENOUSPROPOFOL; formulationADVERSE EFFECTSLIDOCAINE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 5 , May 2007 , pp. 403 - 407
Copyright
Copyright © European Society of Anaesthesiology 2007

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Footnotes

The abstract of this trial was presented as an oral presentation at the 49th Annual Congress of the Association of Anaesthetists of Great Britain and Ireland, held in 2005 at Manchester, UK.

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