Intravenous lidocaine pretreatment with venous occlusion for reducing microemulsion propofol induced pain: Comparison of three doses of lidocaine

Kim, Dae–Hee; Chae, Yun Jeong; Chang, Hyuk Soo; Kim, Jin A; Joe, Han Bum

doi:10.1177/0300060513507391

Cited by 20 publications

(8 citation statements)

References 31 publications

(54 reference statements)

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“…The most effective dose for lignocaine with venous occlusion was 60 mg in one study,[28] whereas 40 mg is the most commonly used dose when premixed with 200 mg of propofol. Venous occlusion with lignocaine is an effective method in relieving propofol-induced pain, Massad et al .…”

Section: Remedies For Pain On Propofol Injectionmentioning

confidence: 99%

Pain on propofol injection: Causes and remedies

DeSousa

2016

Indian J Pharmacol

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Pain on propofol injection (POPI) is a minor problem that all anesthetists face every day. Introduction of several new formulations and hundreds of clinical trials have failed to find its remedy with just one intervention in all patients. This article highlights the causes of POPI and interventions that are used to eliminate this pain in current practice. Relevant articles from Medline and Embase databases were searched and included in this descriptive review with the following conclusions: (1) POPI is due to irritation of venous adventitia leading to release of mediators such as kininogen from kinin cascade. (2) When two or more drugs or measures are used, the incidence of POPI decreases considerably. Hence, the approach to eliminating POPI should be multimodal. (3) Any regimen that includes a drug having local anesthetic effect combined with central sedative/analgesic and rapid injection into a large vein should definitely reduce the risk of POPI to negligible levels.

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Section: Remedies For Pain On Propofol Injectionmentioning

confidence: 99%

Pain on propofol injection: Causes and remedies

DeSousa

2016

Indian J Pharmacol

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“…7,24 Pharmacological, non-pharmacological or a combination of both methods have been used in the attenuation of pain due to propofol injection. Some of them are pre-treatment or addition of lidocaine 13,15,[20][21][22]24 pre-treatment with ondansetron, [11][12][13]15,[17][18][19] opioids as fentanyl 22 , administration of different formulas of propofol 16,23 that include long chain triglycerides (LCT) alone or mediumchain triglycerides (MCT) with LCT, mechanical interventions such as different infusion rates 24 , venous occlusion 20,21 , injection sites 24 , temperature 14 have been used. Unfortunately, none of these have been proven to be ideal.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of prophylactic intravenous ondansetron for attenuation of pain on propofol injection

Manandhar

Manandhar²

2019

J Patan Acad Health Sci

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Introductions: Propofol is a popular intravenous anesthetic agent. One disadvantage of propofol is pain on its injection which can be excruciating at times. Various agents and methods have been tried to attenuate this unpleasant effect. Ondansetron, primarily used as an antiemetic has also been studied to reduce it. Methods: This randomized, prospective, double-blinded, placebo-controlled study was conducted on patients of either sex, American Society of Anesthesiologists (ASA) physical status I & II, undergoing elective surgeries requiring general anesthesia. The patients were randomly divided into ondansetron (A, received intravenous ondansetron 4 mg) and placebo (B, received equivalent volume of normal saline) groups. Manual occlusion of venous drainage was done at mid-arm by an assistant for 1 minute after which 25% of the calculated dose (2 mg/kg) of propofol (1% w/v in lipid base) was injected. Patients were asked by a blinded investigator to score the pain on injection of propofol on 4-point scale: 0=no pain, 1=mild pain, 2=moderate pain, 3=severe pain and compared in between two groups. The p<0.05 was considered significant. Results: There were 96 adult patients, 48 in each group of Ondansetron placebo. Pain on propofol injection was found significantly higher in the placebo group compared to the ondansetron group. (62.5% vs 35.4%). Most of the patients in the ondansetron group had mild pain only, whereas, a significant number of patients in the placebo group had higher degrees of pain on propofol injection. Conclusions: Prophylactic intravenous 4 mg ondansetron is a safe and simple method of attenuating pain on propofol injection.

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“…The direct exposure of nociceptive receptors or free nerve ending in the vein by free propofol can increase the pain on injection. [16,17] Propofol-LCT/MCT was specially proposed to decrease injection pain. Varghese et al [18] reported that when added with lidocaine, both propofol-LCT/MCT and propofol-LCT had similar incidence of injection pain.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of the effect of remifentanil and 2 different doses of esmolol on pain during propofol injection

et al. 2017

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Background: Propofol is associated with pain during injection, which is stressful to patients. The present study was designed to investigate the analgesic effect of pretreatment with remifentanil and esmolol in minimizing propofol injection pain, compared with placebo.Methods: In a randomized, double-blind, prospective trial, 120 patients, scheduled for elective dental surgery under general anesthesia, were randomized to 1 of the 4 treatment arms (n = 30 each) receiving normal saline, remifentanil 0.35 mg/kg, esmolol 0.5 mg/kg, and 1 mg/kg before administration of propofol. During injection of 1% propofol 0.5 mg/kg, pain was evaluated by a 4-point score (0 = none, 1 = mild, 2 = moderate, 3 = severe). Any adverse effects such as hypotension and bradycardia were recorded during the perioperative periods.Results: In all, 120 patients completed this study. There were no significant differences in terms of demographic data. The incidence of pain on injection of propofol was 11 (36.7%) with remifentanil 0.35 mg/kg, 12 (40%) with esmolol 0.5 mg/kg, and 11 (36.7%) with esmolol 1 mg/kg, compared with 25 (83.3%) with normal saline (respectively, P < 0.05). There were no significant differences in the incidence of pain between groups with remifentanil 0.35 mg/kg, and esmolol 0.5 mg/kg and 1 mg/kg. There were no emergence reactions such as hypotension and bradycardia in all groups.Conclusions: Pretreatment with esmolol 0.5 mg/kg and 1 mg/kg and remifentanil 0.35 mg/kg equally decreased pain during propofol injection.Abbreviations: LCT = long-chain triglyceride, MCT = medium-chain triglyceride, NMDA = N-methyl-d-aspartate.

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Intravenous lidocaine pretreatment with venous occlusion for reducing microemulsion propofol induced pain: Comparison of three doses of lidocaine

Cited by 20 publications

References 31 publications

Pain on propofol injection: Causes and remedies

Pain on propofol injection: Causes and remedies

Efficacy of prophylactic intravenous ondansetron for attenuation of pain on propofol injection

Comparative evaluation of the effect of remifentanil and 2 different doses of esmolol on pain during propofol injection

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