SummaryIn a single-blind study of 100 children aged I to 10 years, the minimum eflective dose of lignocaine required to prevent injection pain due to propofol was 0.2 mg.kg-' when veins on the dorsum of the hand were used. This is more than twice the adult value. We concluded that injection pain should not limit the use of propofol in children i f an adequate amount of lignocaine is mixed immediately prior to injection.

Propofol has been used in paediatric anaesthesia since 1985 and an increasing body of evidence has shown that it is a safe, effective induction agent which has dose-related side-effects comparable with other agents. Pain on injection can be ameliorated by the use of antecubital veins or by pre-mixing an adequate amount of lignocaine with propofol immediately prior to administration. The pharmacokinetics of propofol are different in children with their larger central compartment volume and clearance reflected in higher dose requirements for induction and maintenance of anaesthesia. This has important implications when propofol is given for sedation or anaesthesia by continuous infusion. Volume of distribution at steady state (Vss, 1.kg-') Volume of distribution at equilibrium (Vy, bkg-') Volume of the central compartment (Vc, 1.kg-l) Total body clearance (U, ml.kg-'min-') Distribution half-life (THa, min) Metabolic half-life (T,@, min) Elimination half-life ( T, -y, min)

We report the case of a pyogenic granuloma on the shaft of the penis presenting with active bleeding secondary to attempted expression. Previously reported cases have documented such lesions on the prepuce and glans. (Sex Transm Inf 2000;76:217)

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