Propofol injection pain is not alleviated by pretreatment with flurbiprofen axetil, a prodrug of a nonsteroidal antiinflammatory drug

Karasawa, Fujio; Ehata, T; Okuda, Takahiko; Satoh, Tetsuo

doi:10.1007/s005400070020

Cited by 21 publications

(16 citation statements)

References 17 publications

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“…Flurbiprofen, the other NSAID available for intravenous administration, was reported to have no effect on propofol injection pain [19], which is inconsistent with the results of the present study. Karasawa et al [19] administered flurbiprofen 10 min before propofol injection.…”

Section: Discussioncontrasting

confidence: 57%

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How to decrease pain at rapid injection of propofol: effectiveness of flurbiprofen

Nishiyama

2005

J Anesth

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Section: Discussioncontrasting

confidence: 57%

“…Karasawa et al [19] administered flurbiprofen 10 min before propofol injection. The most interesting result of our study is that flurbiprofen administered just before propofol LCT completely abolished propofol injection pain but that a 1-min interval between flurbiprofen and propofol LCT lessened this effect.…”

Section: Discussionmentioning

confidence: 99%

How to decrease pain at rapid injection of propofol: effectiveness of flurbiprofen

Nishiyama

2005

J Anesth

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“…The NNT was also lowest for Lipuro-FA. As a possible mechanism of pain reduction by FA, the analgesic effect of FA as an NSAID is unlikely, because FA is a prodrug that must be metabolized, taking several minutes to exert its analgesic effect [20,21]. Protection of the intima of the vein by FA may also be possible [16], but we could not fi nd any evidence or literature supporting this speculation.…”

Section: Discussioncontrasting

confidence: 46%

Emulsion of flurbiprofen axetil reduces propofol injection pain due to a decrease in free propofol concentration

et al. 2007

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“…Flurbiprofen, diclofenac, and ketorolac were the primary agents explored for potential reduction of pain from propofol injection. 147 177 197-201 Modified propofol formulations containing medium and long chain triglycerides compared with formulations containing long chain triglycerides were effective in 24 trials (0.75, 0.67 to 0.84, fig 9). 5 6 151 177 197 202-219 Combining trials that studied various combinations of standard and modified emulsion formulations with lidocaine had a similar effect (0.61, 0.44 to 0.84).…”

Section: Researchmentioning

confidence: 99%

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

Jalota

Kalira

George

et al. 2011

BMJ

246

227

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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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Propofol injection pain is not alleviated by pretreatment with flurbiprofen axetil, a prodrug of a nonsteroidal antiinflammatory drug

Abstract: Lidocaine, but not LFP, is effective for controlling pain induced by propofol injection. This result suggests that NSAIDs have little effect on pain from propofol injection.

Cited by 21 publications

References 17 publications

How to decrease pain at rapid injection of propofol: effectiveness of flurbiprofen

How to decrease pain at rapid injection of propofol: effectiveness of flurbiprofen

Emulsion of flurbiprofen axetil reduces propofol injection pain due to a decrease in free propofol concentration

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

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