Magnesium sulfate with lidocaine for preventing propofol injection pain: a randomized, double-blind, placebo-controlled trial

Galgon, Richard E.; Strube, Peter; Heier, Jake; Groth, Jeremy; Wang, Sijian; Schroeder, Kristopher M.

doi:10.1007/s00540-014-1892-9

Cited by 15 publications

(8 citation statements)

References 27 publications

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“…It can be applied to volume replacement (filling the intravascular space) and fluid replacement (extravascular deficit) [9] . Magnesium is not only the physiological calcium channel blocker, but also an antagonizer of NMDA receptors, which may interfere in the ion channels of K + and Ca 2+ , resulting in reduction of pain perception [20] . In previous studies [5,21,22] , pretreatment with magnesium sulfate was effective in the prevention of propofol-induced pain without considering injection pain from magnesium itself.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of different fluids preload on propofol injection pain: A randomized, controlled, double-blinded study

Yuan

Luo

Liu

et al. 2016

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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Injection pain of propofol remains a common clinical problem. Previous studies demonstrated that propofol injection pain was alleviated by applying nitroglycerin ointment to the skin of injection site, which inspires us to test whether venous vasodilation induced by fluid preload could alleviate the pain. Different types or volumes of fluid preload were compared. 200 ASA I-II adult patients were randomly assigned to five groups of 40 each. A 20 G cannula was established on the dorsum or wrist of the hand. When fluid preload given with Plasma-Lyte A 100 mL (P100 group), 250 mL (P250 group), 500 mL (P500 group), 0.9% saline 500 mL (N500 group) or Gelofusine 500 mL (G500 group) was completed within 30 min, respectively, Propofol (0.5 mg/kg, 1%) was injected at a rate of 0.5 mL/s. A blind investigator assessed the pain using a four-point scale. Incidence of pain in P100, P250, and P500 groups was 87.5%, 57.5% and 35%, respectively (P<0.05). The median pain intensity score was significantly lower in P500 group than that in P250 and P100 groups (P<0.05 and P<0.01, respectively). Comparison of the effect of different types of solution preload indicated that the highest incidence of pain was in N500 group (62.5%) (N500 vs. P500, P=0.014; N500 vs. G500, P=0.007). The median pain intensity score in N500 group was higher than that in P500 group (P<0.05) and G500 group (P<0.05). There was no significant difference between P500 and G500 groups. It is suggested that Plasma-Lyte A or Gelofusine preload with 500 mL before propofol injection is effective in alleviating propofol-induced pain.

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Section: Discussionmentioning

confidence: 99%

Efficacy of different fluids preload on propofol injection pain: A randomized, controlled, double-blinded study

Yuan

Luo

Liu

et al. 2016

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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“…In the published data, the incidence of pain due to propofol injection is 46% in untreated patients [ 10 ]. We hypothesized a 50% reduction in the incidence of pain after propofol administration based on an alpha of 0.05 and a power of 80%.…”

Section: Methodsmentioning

confidence: 99%

Comparison Between Intravenous Nalbuphine and Lidocaine in Reducing Propofol-Induced Injection Pain During Gastroscopy: A Randomized Controlled Trial

et al. 2020

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Introduction Intravenous propofol anesthesia is widely used in painless endoscopy. However, propofol injection pain is a common adverse effect. This study investigated the effects of nalbuphine and lidocaine in reducing propofol-induced injection pain. Methods In this double-blind, randomized study, 330 patients were randomly divided into three groups by using a random number table: the nalbuphine group (N), lidocaine group (L), and control group (C). The N, L, and C groups received either 0.1 mg/kg nalbuphine, 0.5 mg/kg lidocaine, or an equivalent volume of normal saline, respectively, as pretreatment drug. Then propofol was manually injected. The primary outcome of this study was the incidence of propofol-induced injection pain, and secondary outcomes included the severity of propofol-induced injection pain, vital signs, and adverse events, including hypotension, bradycardia (< 50 beats/min), hypoxemia (SpO 2 < 90%), drowsiness, physical movement, and cough. Results The percentages of patients with propofol injection pain were higher in group C than in group N and group L (64, 34, and 27%, respectively, p < 0.05). The percentage of patients with severe pain after propofol injection was significantly higher in group C than in group N and group L (12, 1, and 0%, respectively, p < 0.05). The doses of propofol in group C and group L were significantly higher than that in group N. More patients suffered hypoxemia in group N than in group C and group L. Then, less patients got physical movement and cough in group N. Conclusions Pretreatment with nalbuphine 0.1 mg/kg was effective in reducing propofol-induced injection pain and propofol consumption. Propofol combined with nalbuphine can be safely and effectively used during gastroscopy. Trial Registration Chinese Clinical Trial Registry; ChiCTR1900025438.

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“…The pain from the propofol injection was reduced by 30% due to the 20-mg HnBB pretreatment, similar to the 37% reduction with lidocaine pretreatment [24] and the 33% reduction with low-dose esmolol [25]. However, a combination of lidocaine and nitroglycerine pretreatment has been found to reduce propofol injection pain to 7%, which is better than using either lidocaine or HnBB alone.…”

Section: Discussionmentioning

confidence: 82%

Hyoscine N-Butylbromide for Preventing Propofol Injection Pain: A Randomized, Placebo-Controlled and Double-Blind Study

Sargın¹,

Uluer²,

Aydoğan³

2018

Med Princ Pract

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Objective: In this study, the aim was to investigate the effect of hyoscine N-butylbromide (HnBB) pretreatment on pain during propofol injection. Subjects and Methods: In this prospective, randomized, placebo-controlled and double-blind trial, 60 patients scheduled to undergo routine outpatient surgery under general anesthesia were randomly allocated to 2 groups, the HnBB (n = 30) and sodium chloride (n = 30) groups. Twenty seconds after the injection of 20 mg HnBB or 0.9 % sodium chloride, a 50-mg dose of propofol was injected in 2–3 s. Ten seconds later, the pain intensity was assessed using a 4-point scale: no pain (0), mild (1), moderate (2), and severe (3) pain. The Student t test was used for the analysis of parametric data and the Pearson χ² test for categorical data. Results: The occurrence of pain in the HnBB group (43.3%) was significantly lower than the control group (73.3%) (p < 0.018). Of the 30 patients in each group, 10 in the control group and 3 in the HnBB group experienced severe pain (p = 0.001). Conclusions: Pretreatment with 20 mg HnBB significantly reduced propofol injection pain compared to placebo.

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Magnesium sulfate with lidocaine for preventing propofol injection pain: a randomized, double-blind, placebo-controlled trial

Cited by 15 publications

References 27 publications

Efficacy of different fluids preload on propofol injection pain: A randomized, controlled, double-blinded study

Efficacy of different fluids preload on propofol injection pain: A randomized, controlled, double-blinded study

Comparison Between Intravenous Nalbuphine and Lidocaine in Reducing Propofol-Induced Injection Pain During Gastroscopy: A Randomized Controlled Trial

Hyoscine N-Butylbromide for Preventing Propofol Injection Pain: A Randomized, Placebo-Controlled and Double-Blind Study

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