Reduction of propofol injection pain by utilizing the gate control theory

Kim, Sae Young; Jeong, Dong Wook; Jung, Minji; Kim, Jin Mo

doi:10.4097/kjae.2011.61.4.288

Cited by 5 publications

(6 citation statements)

References 26 publications

(23 reference statements)

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“…10,12 Using this strategy, the overall incidence of pain on lipid emulsion propofol injection has been reported to range from 8% to 42%, while the incidence of moderate to severe pain ranges from 2% to 16%. 12,24–28 In the present study, the overall incidence of injection pain following microemulsion propofol administration in patients in group L40 was 77.3% and the incidence of moderate to severe injection pain was 63.6%, which is comparable to previous data. 13 These findings suggest that pretreatment with 40 mg lidocaine in the clinical setting is insufficient to prevent injection pain following microemulsion propofol.…”

Section: Discussionsupporting

confidence: 90%

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

et al. 2014

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Objective: Pretreatment with intravenous 40 mg or 0.5 mg/kg lidocaine with venous occlusion is recommended to prevent pain following injection of lipid emulsion propofol. This approach is not sufficient to prevent pain from the injection of microemulsion propofol. The present study investigated whether a higher dose of lidocaine pretreatment with venous occlusion would be more effective for reducing pain following injection of microemulsion propofol compared with 40 mg lidocaine. Methods: Patients undergoing elective surgery were randomly assigned to one of three groups: pretreatment with 40 mg (group L40), 60 mg (group L60) or 80 mg (group L80) lidocaine intravenously with venous occlusion, followed by injection with microemulsion propofol 1 min later. Pain was assessed on a four-point scale (severe, moderate, mild, none) based on physical responses to the injection. Results: A total of 68 patients were included in the final analysis. Pain severity and incidence were significantly lower in patients in group L60 and L80 compared with patients in group L40. There were no statistically significant differences in pain incidence or severity between group L60 and group L80. Conclusions: Pretreatment with 60 mg lidocaine intravenously with venous occlusion may be the most effective minimum dose for reducing injection pain following microemulsion propofol administration for induction of anaesthesia.

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Section: Discussionsupporting

confidence: 90%

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

et al. 2014

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“…Regarding the decrease of pain associated with intravenous injection of propofol, several studies used pharmacologic and non-pharmacologic methods. Particularly, research assessed variations in the injection speed and carrier fluids, dilutions, temperatures, and adjuvant therapies using anesthetics [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of flurbiprofen axetil in the prevention of pain on propofol injection: A systematic review and meta-analysis

Bao

2014

Med Sci Monit

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BackgroundPain on injection is an acknowledged adverse effect (AE) of propofol administration for the induction of general anesthesia. Flurbiprofen axetil has been reported to reduce the pain of injection. However, results of published papers on the efficacy of flurbiprofen axetil in managing pain on injection of propofol are inconsistent.Material/MethodsWe conducted a comprehensive meta-analysis of studies to appraise the efficacy and safety of flurbiprofen axetil for controlling pain induced by propofol injection. The pooled risk ratio (RR) with corresponding 95% confidence intervals (CI) was calculated employing fixed- or random-effects models, depending upon the heterogeneity of the included trials.ResultsCompared with the placebo group, flurbiprofen axetil allows more patients to have no pain (RR 3.51, 95% CI 2.22–5.55, p=0.000), and decreases the cumulative number of patients with mild, moderate, and severe pain on injecting propofol (RR 0.70, 95% CI 0.58–0.86, p=0.000; RR 0.59, 95% CI 0.46–0.75, p=0.000; RR 0.25, 95% CI 0.16–0.38, p=0.000, respectively). In the stratified analysis by the doses, flurbiprofen axetil at a dose of over 50 mg was found to be effective in reducing propofol-induced pain on injection; however, there were no significant differences in relieving pain between treatment and placebo groups with flurbiprofen axetil at a dose of 25 mg. In terms of drug safety, there were no adverse effects (AEs) reported between flurbiprofen axetil-based regimens and placebo regimens.ConclusionsFlurbiprofen axetil, an injectable prodrug of flurbiprofen, can significantly prevent or relieve the pain induced by propofol injection. More studies are required to assess its adverse effects.

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“…Many medications have been investigated and demonstrated some efficacy in reducing this incidence, including ondansetron, dexamethasone, lidocaine, magnesium sulfate, ketamine, gabapentin, and nitroglycerine 1–10 . Other modalities have also shown some utility including alteration of the injectate temperature, manual palpation of the intravenous site, Valsalva maneuver, and use of auto-coinduction 11,14–19 …”

Section: Discussionmentioning

confidence: 99%

The Effect of Vibration on Pain During Intravenous Injection of Propofol

Hwang¹,

Nash²,

Yedlin

et al. 2021

Ann Plast Surg

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Purpose Pain is a common side effect of intravenous injection of propofol. We conducted a randomized, prospective, single-blinded controlled trial to assess the efficacy of vibration analgesia on pain during propofol infusion in ambulatory surgery. Methods After institutional review board approval, 100 patients undergoing elective ambulatory surgery with general anesthesia were randomized into 2 groups. A control group (n = 50) consisted of patients who received infusion of propofol without vibration analgesia. A treatment group (n = 50) consisted of patients who received infusion of propofol with vibration analgesia using the Buzzy device. Pain was assessed using a 4-point pain manifestation scale scored by 2 independent, blinded observers. Results Participants in the treatment group with vibration analgesia were 0.47 times less likely (95% confidence interval, 0.24–0.94; P = 0.03) to experience any pain than the control group. The median summative pain score in the treatment group was significantly less than that of the control group [1 (interquartile range, 1–2) vs 2 (interquartile range, 2–4); P < 0.01] among participants who experienced any pain. Agreement between the 2 blinded observers regarding pain scores was excellent with κ w = 0.82 (P < 0.001). Age, sex, body mass index, needle location or size, and medication doses did not differ significantly between the 2 groups. Conclusion Vibration analgesia is an effective, low-risk modality that reduces the pain of intravenous propofol injection in general anesthesia.

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Reduction of propofol injection pain by utilizing the gate control theory

Cited by 5 publications

References 26 publications

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

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

Efficacy and safety of flurbiprofen axetil in the prevention of pain on propofol injection: A systematic review and meta-analysis

The Effect of Vibration on Pain During Intravenous Injection of Propofol

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