Tourniquet at 50 mm Hg Followed by Intravenous Lidocaine Diminishes Hand Pain Associated With Propofol Injection

Mangar, Devanand; Holak, Elena J.

doi:10.1213/00000539-199202000-00014

Cited by 133 publications

(66 citation statements)

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“…bolus or tourniquet application or by mixing with propofol. Mangar et al [15] proved that lidocaine given to proximal region of the arm after tourniquet apply is more effective on reducing the pain related to propofol injection compared to the placebo. Although there is no certain explanation for the mechanism of this case, it is a common idea that the possible effect of lidocaine by blocking the nerves can hinder the effect of stimulative membranes in veins [16].…”

Section: Discussionmentioning

confidence: 99%

Comparison of hemodynamic response for intubation and propofol pain caused by lidocaine administration with infusion and tourniquet

Deniz¹,

Alparslan²,

Ak³

et al. 2017

Med-Science

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Propofol is one of the most widely used i.v. anesthetic agent. Nevertheless, pain following i.v. administration of propofol is an important problem in anesthesia induction. A wide range of studies have been performed related to lidocaine effects on propofol injection pain and hemodynamic response to intubation. However, effect of both situations are seldomly studied in the literature. In our study we compare lidocaine effects on propofol injection pain and hemodynamic response to intubation which is given by infusion or under tourniquet as i.v. bolus. 70 patients attended to the study are separated randomly into two groups of 35 patients. Prior to induction, lidocaine has been infused with infusion pump as to be completed in 2 minutes with concentration of 2%, total dosed 1mg/kg in infusion group (Group I, n=35). In this group, after half of the total lidocaine dose is infused (1st minute), anesthesia induction has been started by giving 40 mg propofol of 1% in 10 seconds with infusion pump. In tourniquet group (Group T, n=35) prior to induction 1mg/kg lidocaine has been given as bolus by applying tourniquet with 70 mm/Hg pressure to the arm that is established vascular access and tourniquet has been remained for 60 seconds. After opening the tourniquet, induction has been started by giving 40 mg propofol of 1% in 10 seconds with infusion pump. During induction, patient"s consciousness was evaluated by questioning his/her name and age after administering 1/4 (VRS0), 1/2 (VRS1), and 3/4 (VRS2) of total propofol dose. Confused patients were eliminated and the sense of pain caused by propofol was evaluated in study patients. The results were recorded according to four-point categorical verbal rating scale (VRS). For groups, the pulse rates and mean arterial pressures before lidocaine administration (T0), after lidocaine (T1), immediately after intubation (T2) and 10th minute after intubation (T3) were recorded. No differences detected among the groups with regards to demographic data and side effects. (p>0.05). No significant differences statically detected when comparing the heart rate (HR), mean arterial pressure (MAP) and pain scores of groups for all times (p>0.05). It is concluded that administering lidocaine by infusion technic may be an alternative method for tourniquet method on suppressing hemodynamic response related to tracheal intubation and on preventing injection pain related to propofol.

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Section: Discussionmentioning

confidence: 99%

Comparison of hemodynamic response for intubation and propofol pain caused by lidocaine administration with infusion and tourniquet

Deniz¹,

Alparslan²,

Ak³

et al. 2017

Med-Science

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“…1 Lidocaine is the most effective agent in reducing this pain especially if given first with a venous tourniquet inflated to 50 mmHg. 3,4 The strategy most commonly used clinically, however, is mixing lidocaine with propofol. The amount of lidocaine mixed with propofol varies but in adults, 0.1 mg·kg -1 seems to be effective, [5][6][7][8] whereas children seem to need about 0.2 mg·kg -1 .…”

Section: Discussionmentioning

confidence: 99%

In children, nitrous oxide decreases pain on injection of propofol mixed with lidocaine

Beh

Splinter

Kim

2002

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To investigate if 50% nitrous oxide reduces the pain during injection of propofol mixed with lidocaine in children.M Me et th ho od ds s: : Healthy children undergoing iv induction of general anesthesia for elective surgery were recruited into this prospective, randomized, double-blind study. None of the patients received any premedication except for eutectic mixture of local anesthetics cream. Before induction of anesthesia with propofol 1% mixed with lidocaine 0.05% (propofol dose 3 mg·kg -1 ), the treatment group received 50% N 2 O in O 2 and the control group received 100% oxygen. Pain due to propofol administration was rated with a four-point behavioural scale: none, mild, moderate or severe.R Re es su ul lt ts s: : There were 28 subjects in the control group and 26 subjects in the treatment group. Demographic data were similar in both groups. The incidence of pain at induction was 4% after N 2 O and 36% in the control group, P < 0.01. No patients had severe pain. Most patients had mild pain. Three of the ten patients with pain in the control group had moderate pain. The number needed to treat was 3:1.C Co on nc cl lu us si io on n: : Nitrous oxide reduces pain during induction with propofol mixed with lidocaine in healthy children. ROPOFOL has many beneficial pharmacodynamic and pharmacokinetic properties. However, one of its major adverse effects is injection pain. Incidence of propofol injection pain in children varies between 28% and 85%. 1 Lidocaine is commonly mixed with propofol to reduce pain of propofol administration. This, however, does not completely remove the pain in all cases. We hypothesized that 50% N 2 O in O 2 would further reduce the pain of propofol administration in children. Objectif

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“…However, all had variable results. [4][5][6][7][8][9][10][11][12][13] Many factors like site of injection, size of vein, speed of injection, buffering effect of blood, temperature of propofol and concomitant use of drugs such as local anaesthetics, opiates, etc., appear to affect the incidence of pain [14][15][16] . A number of both pharmacological (e.g., pretreatment with lignocaine, ondansetron, ketorolac, nafamostat, ketamine or topical nitroglycerine application with propofol, diluting propofol with 5% dextrose or 10% intralipid and using mediumand small-chain triglycerides) and nonpharmacological methods have been used with variable results and the research for the ideal agent to decrease pain on propofol injection is still going on.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study on the Effectiveness of Granisetron and Metoclopramide for Reducing Propofol Injection Pain

Johnson¹

2017

jmscr

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Background: Propofol is one of the widely used intravenousanaesthetics, although pain on injection still remains a considerable concern for the anaesthesiologists. The aim of my randomized double blinded study was to compare the effectiveness of Granisetron and Metoclopramide in reducing Propofol .1%) with mild pain (VRS 1), 20 patients (5.3%) with moderate pain (VRS 2), 14 patients (3.7%) with severe pain (VRS 3). 151 patients (39.7%) complained of pain in group pretreated with Metoclopramide that is is 76 patients (20%) with mild Pain (VRS 1), 57 patients (15%) with moderate pain (VRS 2) , 18 patients (4.7%) with severe pain (VRS 3). The presence and severity of pain was less in the Granisetron group compared withMetoclopramide group (P< 0.05

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Tourniquet at 50 mm Hg Followed by Intravenous Lidocaine Diminishes Hand Pain Associated With Propofol Injection

Cited by 133 publications

References 0 publications

Comparison of hemodynamic response for intubation and propofol pain caused by lidocaine administration with infusion and tourniquet

Comparison of hemodynamic response for intubation and propofol pain caused by lidocaine administration with infusion and tourniquet

In children, nitrous oxide decreases pain on injection of propofol mixed with lidocaine

Comparative Study on the Effectiveness of Granisetron and Metoclopramide for Reducing Propofol Injection Pain

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