Effect of Lidocaine Volume and Concentration on Preventing Incidence and Severity of Propofol Injection Pain

Gharavi, Mohammad Bagher; Sabzevari, Alireza; Ghorbanian, Ehsanolah; Sajadi, Rasoul; Akhondi, Mohammad Mehdi

doi:10.5812/ircmj.16099

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…This was in accordance with the study by Gharavi M et al, in which there was significant difference in pain perception using NRS pain score between the group B (0.4%) and group A (2%). 18 This study also showed a highly significant reduction in the withdrawal movements in the group A compared to the group B with a p value of 0.041. The incidence of pain in the group A was 8% (6 patients) and the highest score recorded was 1, according to the WRS score, while in the group B , the incidence of pain with propofol injection was 27% (14 patients) and the highest score recorded was one according to the WRS score.…”

Section: Discussionsupporting

confidence: 55%

“…Taking 80% power and a 5% level of significance, a sample size of total 126 patients, 63 in each group, was found to be sufficient to detect a clinically important difference of 20% between groups in using a two-tailed ztest of proportions. The 20% assumption was made on the basis of findings of a study done by Gharavi et al 18…”

Section: Sample Sizementioning

confidence: 99%

“…Gharavi M et al, studied the effect of lidocaine volume and concentration on preventing incidence and severity of propofol injection pain in 4 to 8 years old children and our research aims to compare this effect in adults. 18 The aim of this study was to investigate the efficacy of lidocaine at two different doses (0.4% and 2%) in mitigating the pain caused by injection of propofol. This was measured using two pain scores, Numeric Rating Scale (NRS), a subjective score in which patient rate his/her pain experience and an objective score, Withdrawl Response Score (WRS), in which investigator assesses response according to withdrawl movements of limbs.…”

Section: Introductionmentioning

confidence: 99%

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A randomized controlled trial to compare effects of different volume and concentration of lidocaine for preventing propofol injection pain in adults

Patyal

Verma

Buddhi

2019

Int J Basic Clin Pharmacol

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Background: Pain on propofol injection is an unwanted effect which can lead to decreased patient satisfaction. Although many studies have shown that pre-treatment with lidocaine injection is effective in this pain, nevertheless, very few studies have been done on different concentration and volume of lidocaine, effective of reducing pain significantly. Objective of the current study was to assess and compare the efficacy of intravenous lidocaine with 0.4% and 2% concentration in reducing the incidence and severity of propofol injection pain.Methods: A total of 126 American Society of Anesthesiologist grade I and II patients with age ≥18 years, scheduled for an elective surgery, were enrolled in the study. Patients were randomized into two equal groups of 63 each. Group A (n = 63) received pretreatment with 0.4% lidocaine and group B (n = 63) received 2% lidocaine. Propofol injection pain was measured by using Numeric Rating Scale (NRS) and Withdrawl Response Scale (WRS). Unpaired t test, ANOVA and Chi square test were used for statistical analysis.Results: A statistically significant decrease in the pain was recorded in group A (0.4% lidocaine) as compared to group B (2% lidocaine). Using NRS scale, 12% of patients in group A as compared to 33% patients of group B, experienced pain (p =0.02); while using WRS, 8% patients of group A as compared to 27% group B patients experienced pain (p= 0.04).Conclusions: The pain on injection of propofol is significantly decreased by the use of 0.4% lidocaine in comparison with 2% Lidocaine.

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Section: Discussionsupporting

confidence: 55%

Section: Sample Sizementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A randomized controlled trial to compare effects of different volume and concentration of lidocaine for preventing propofol injection pain in adults

Patyal

Verma

Buddhi

2019

Int J Basic Clin Pharmacol

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“…21 Among these studies, the most commonly accepted technique is the administration of lignocaine just before the injection of propofol. 22 A study investigating the optimal dose of lidocaine for the prevention of injection pain due to propofol, found that the addition of 0.1mg/kg of lidocaine to 2.5 mg/kg of propofol decreased the pain, whereas increasing the dose of lidocaine to 0.2 or 0.4 mg/kg did not bring additional benefit. 23 Another study concluded that, the addition of 10 mg of lidocaine to propofol 2 mg/kg, or the administration of 1 mg/kg of lidocaine 30 seconds before the administration of propofol 2 mg/kg, effectively decreased pain caused by propofol injection.…”

Section: Discussionmentioning

confidence: 99%

Optimal dose of methylprednisolone for reduction of propofol injection pain: A randomized, double-blind, placebo controlled study

Singh¹,

Mudassar²,

Shivanna³

et al. 2020

IJCA

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Introduction and Aims: Propofol (2,6-di-isopropylphenol) used for the induction of anaesthesia often causes mild to severe pain on injection, for which various methods have been tried, but with conflicting results. We designed a placebo-controlled, doubleblind study to compare the efficacy of different doses of intravenous methylprednisolone for attenuation of propofol injection pain. Materials and Methods: One hundred twenty adult patients belonging to the American Society of Anaesthesiologists (ASA) physical Status II and III, between 21 and 60 years, scheduled for elective cardiac surgery, were divided into four groups: saline (group S, n=30), methylprednisolone 40mg (Group methylprednisolone 1 MP1, n=30), methylprednisolone 125mg (group methylprednisolone 2 MP2, n=30) and methylprednisolone 250mg (Group methylprednisolone 3 MP3, n=30) diluted into 2ml of distilled water. Study drugs were administered after tourniquet application and occlusion was released after 1 min and 1/4th of the total dose of propofol (2mg/kg) was administered at the rate of 0.5ml per second. Pain on propofol injection was assessed by four-point verbal rating scale. Statistical methods used included Chi-square test/Fisher's exact test and Student's t-test. Results: Demographic variables were similar among all the groups. The overall incidence of pain was 70% in the saline group, 53.33% in MP1 and 33.33% in both MP2 & MP3. Pain intensity was significantly less in patients receiving MP2 & MP3 drugs for pre-treatment than those receiving saline (P<0.05). Pre-treatment with MP3 drug itself produced pain with incidence of 16.6%. Conclusions: Pre-treatment with either 125mg or 250mg intravenous methylprednisolone was found to be effective in reducing propofol injection-induced pain. But pre-treatment with 250 mg MP itself was associated with pain during injection.

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“…[19] Among these studies, the most commonly accepted technique is the administration of lignocaine just before the injection of propofol. [20]…”

Section: Discussionmentioning

confidence: 99%

Efficacy of methylprednisolone and lignocaine on propofol injection pain: A randomised, double-blind, prospective study in adult cardiac surgical patients

et al. 2016

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Background and Aims:Propofol (2, 6-di-isopropylphenol) used for the induction of anaesthesia often causes mild to severe pain or discomfort on injection. We designed this double-blind study to compare the efficacy of methylprednisolone and lignocaine in reducing the pain of propofol injection in patients scheduled for cardiac surgery.Methods:A total of 165 adult patients, scheduled for elective cardiac surgery, were divided into three groups: saline (group S, n = 55), lignocaine 20 mg (Group L, n = 55) and methylprednisolone 125 mg diluted into 2 ml of distilled water (Group MP, n = 55). Drugs were administered after tourniquet application and occlusion was released after 1 min and 1/4th of the total dose of propofol (2 mg/kg) was administered at the rate of 0.5 ml/s. Pain on propofol injection was evaluated by four-point verbal rating scale. Statistical methods used included Student's t-test and Chi-square test/Fisher's exact test.Results:The overall incidence of pain was 70.9% in the saline group, 30.9% in the lignocaine group and 36.4% in the methylprednisolone group. The intensity of pain was significantly less in patients receiving methylprednisolone and lignocaine than those receiving saline (P < 0.012).Conclusion:Pre-treatment with intravenous methylprednisolone was found to be as effective as lignocaine in reducing propofol injection-induced pain.

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Effect of Lidocaine Volume and Concentration on Preventing Incidence and Severity of Propofol Injection Pain

Cited by 8 publications

References 16 publications

A randomized controlled trial to compare effects of different volume and concentration of lidocaine for preventing propofol injection pain in adults

A randomized controlled trial to compare effects of different volume and concentration of lidocaine for preventing propofol injection pain in adults

Optimal dose of methylprednisolone for reduction of propofol injection pain: A randomized, double-blind, placebo controlled study

Efficacy of methylprednisolone and lignocaine on propofol injection pain: A randomised, double-blind, prospective study in adult cardiac surgical patients

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