Efficacité d’une faible dose de kétamine dans la réduction de la douleur liée à l’injection de propofol

Tarmiz, K.; Ferhi, Fehmi; Toumi, M.; Slama, A. Ben; Benjazia, K.

doi:10.1016/j.annfar.2008.12.014

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…These methods do not eradicate pain completely, but do decrease the incidence or severity of injection pain. Of these several agents, lidocaine is the most commonly used in clinical practice [19]. The most common method used in routine is the adding of 10 -40 mg lidocaine to the syringe of propofol immediately prior to use.…”

Section: Discussionmentioning

confidence: 99%

Pain on Injection of Propofol: Efficacy of Paracetamol and Lidocaine

Khouadja¹,

Arnous²,

Tarmiz³

et al. 2014

OJAnes

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Background and Objectives: Propofol remains the most common drug for induction of general anaesthesia, although it causes considerable pain on injection. None of the commonly used methods completely attenuate this discomfort. We aimed to investigate the effect of i.v. paracetamol pretreatment on the propofol injection pain. Materials and Methods: A prospective randomized double-blind study was conducted on 180 patients, ASA I or II status, scheduled to undergo elective surgery. They were randomly assigned to one of the three groups of 60 each. Groups I, II, III were pretreated with 40 mg of lidocaine in saline, 100 mg of paracetamol and 10 ml of saline, respectively. All patients had an 18-gauge catheter inserted into a superficial radial vein. After 2 min of venous occlusion, one-fourth of the total propofol dose was injected into the vein over a period of 20 seconds. During the injection of both pretreatment solution and propofol, a blinded researcher assessed the patient's pain level using a four-point verbal rating scale (VRS) (none = 0, mild = 1, moderate = 2, and severe = 3). X 2 test and Kruskal-Wallis tests were used for the statistical analysis. For all analyses, differences were considered to be significant at P < 0.05. Results: The three groups were comparable in respect to patient's characteristics. The incidence of pain on injection of propofol in placebo, i.v. paracetamol and lidocaïne groups were 85%, 36%, 21% respectively (p < 0.05). Intensity and severity of propofol induced pain were comparable between paracetamol and lidocaine groups. Conclusion: Pretreatment using i.v. paracetamol was found to be effective in reducing propofol injection-induced pain.

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Section: Discussionmentioning

confidence: 99%

Pain on Injection of Propofol: Efficacy of Paracetamol and Lidocaine

Khouadja¹,

Arnous²,

Tarmiz³

et al. 2014

OJAnes

Self Cite

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Prevention of pain on injection of propofol: systematic review and meta-analysis

Jalota

Kalira

George

et al. 2011

BMJ

236

226

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Objective To systematically determine the most efficacious approach for preventing pain on injection of propofol. Design Systematic review and meta-analysis. Data sources PubMed, Embase, Cochrane Library, www.clinicaltrials.gov, and hand searching from the reference lists of identified papers. Study selection Randomised controlled trials comparing drug and non-drug interventions with placebo or another intervention to alleviate pain on injection of propofol in adults. Results Data were analysed from 177 randomised controlled trials totalling 25 260 adults. The overall risk of pain from propofol injection alone was about 60%. Using an antecubital vein instead of a hand vein was the most effective single intervention (relative risk 0.14, 95% confidence interval 0.07 to 0.30). Pretreatment using lidocaine (lignocaine) in conjunction with venous occlusion was similarly effective (0.29, 0.22 to 0.38). Other effective interventions were a lidocaine-propofol admixture (0.40, 0.33 to 0.48); pretreatment with lidocaine (0.47, 0.40 to 0.56), opioids (0.49, 0.41 to 0.59), ketamine (0.52, 0.46 to 0.57), or non-steroidal anti-inflammatory drugs (0.67, 0.49 to 0.91); and propofol emulsions containing medium and long chain triglycerides (0.75, 0.67 to 0.84). Statistical testing of indirect comparisons showed that use of the antecubital vein and pretreatment using lidocaine along with venous occlusion to be more efficacious than the other interventions. Conclusions The two most efficacious interventions to reduce pain on injection of propofol were use of the antecubital vein, or pretreatment using lidocaine in conjunction with venous occlusion when the hand vein was chosen. Under the assumption of independent efficacy a third practical alternative could be pretreatment of the hand vein with lidocaine or ketamine and use of a propofol emulsion containing medium and long chain triglycerides. Although not the most effective intervention on its own, a small dose of opioids before induction halved the risk of pain from the injection and thus can generally be recommended unless contraindicated.

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Efficacité d’une faible dose de kétamine dans la réduction de la douleur liée à l’injection de propofol

Cited by 2 publications

References 5 publications

Pain on Injection of Propofol: Efficacy of Paracetamol and Lidocaine

Pain on Injection of Propofol: Efficacy of Paracetamol and Lidocaine

Prevention of pain on injection of propofol: systematic review and meta-analysis

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