Injection pain with propofol Reduction with aspiration of blood

Abstract

Summary A randomised, controlled, single-blind

Efficacy of microfiltration in decreasing propofol‐induced pain*

“…If propofol present in the aqueous phase is in the form of undissolved particles, their removal by filtration may explain the reduction in pain we observed. Blood buffering may ameliorate this process as both aspiration of blood into the propofol syringe and injection into a large vein reduces the incidence of pain [2, 5]. Naked‐eye inspection shows that the emulsion emerges as a stream of droplets.…”

“…Several methods have been described to minimise propofol‐induced pain. These include non‐pharmacological strategies such as injection in the antecubital fossa, cooling, dilution with blood and the use of glass syringes [2, 4–6]. Pharmacological techniques are numerous including dilution with lipid, premedication, pretreatment with non‐steroidal drugs, local anaesthetics, opioids, thiopentone, metoclopramide and glyceryl trinitrate patch [3, 7–13].…”

Current Perspectives on Pain upon Injection of Drugs

“…[68][69][70]102 If necessary, the drug product labeling may include a recommendation that a specific vehicle or local anesthetic or other protective agent be administered concurrently with the drug. 40,41,43,45,47,57,66,[76][77][78][79]82,83,[87][88][89]91,[93][94][95]100,101,107,108,116,121 The addition of compounds such as procaine or lidocaine to an injection will block the transmission and perception of pain (see mediation of pain) associated with injection via their action on sodium receptors. However, the question that needs to be addressed is whether this is a desirable to utilize this multiple drug approach for long-term therapy.…”

Effect of lidocaine on pain caused by injection of propofol: Comparison of three methods at two injection rates

“…Scott et al [7] reported that the duration of exposure to the vein wall, which mostly depends on the injection rate, is of importance, and that this hypothesis is compatible with the time lag in the onset of the pain and suggests an association with pain mediators such as kininogens. They also reported that injecting into a large vein reduced pain and that this was, presumably, because of the low concentration of propofol due to dilution with blood; however, the effect and the mechanism of diluted propofol are still controversial [9][10][11]. The effect of the temperature of propofol is also not yet clear [12,13].…”