Reduction of pain on injection of propofol: combination of nitroglycerin and lidocaine.
Summary of "Reduction of pain on injection of propofol: combination of nitroglycerin and lidocaine."
PURPOSE:
Pain on propofol injection is a common adverse effect. This study examined the effect of a combination of nitroglycerin and lidocaine on pain during propofol injection compared to lidocaine alone.
METHODS:
In a double-blind, prospective trial, 90 patients scheduled to undergo elective plastic surgery were allocated randomly to three groups, to receive lidocaine 20 mg (n = 30), a combination of lidocaine 20 mg and nitroglycerin 0.1 μg/kg (n = 30), or normal saline as a placebo (n = 30), with venous occlusion for 1 min, followed by the administration of 25 % of the total calculated dose of propofol (2 mg/kg) into a dorsal hand vein. The pain intensity during the propofol injection was assessed using a four-point scale (0 = none, 1 = mild, 2 = moderate, 3 = severe). Hemodynamic variables-mean arterial pressure and heart rate-were measured during the preoperative and intraoperative periods.
RESULTS:
A significantly higher proportion of patients in the placebo group (83 %) experienced pain compared to the lidocaine and combination groups (43 and 7 %, respectively; both, P < 0.01). The incidence of pain in the combination group was lower than that in the lidocaine group (P < 0.01). The pain score (median) was lower in the lidocaine (0) and combination (0) groups than in the placebo group (2); (P < 0.01). The hemodynamic variables were similar in the three groups.
CONCLUSION:
A combination of nitroglycerin 0.1 μg/kg and lidocaine 20 mg with venous occlusion for 1 min was more effective than lidocaine 20 mg alone in decreasing pain during propofol injection.
Affiliation
Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, 130 Dongdukro, Jung-gu, Daegu, 700-721, Republic of Korea, jeon68@knu.ac.kr.
Journal Details
This article was published in the following journal.
Name: Journal of anesthesia
ISSN: 1438-8359
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22526437
- DOI: http://dx.doi.org/10.1007/s00540-012-1394-6
Medical and Biotech [MESH] Definitions
Propofol
An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.
Benzyl Alcohol
A colorless liquid with a sharp burning taste and slight odor. It is used as a local anesthetic and to reduce pain associated with LIDOCAINE injection. Also, it is used in the manufacture of other benzyl compounds, as a pharmaceutic aid, and in perfumery and flavoring.
Hypophysectomy, Chemical
Total or subtotal destruction of the pituitary gland by chemical injection. It is usually achieved by injection of ethyl alcohol via trans-sphenoidal cannulation under stereotaxic control. It is usually performed for the treatment of intractable pain.
Pain, Referred
A type of pain that is perceived in an area away from the site where the pain arises, such as facial pain caused by lesion of the VAGUS NERVE, or throat problem generating referred pain in the ear.
Facial Pain
Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as FACIAL PAIN SYNDROMES.
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