A randomized double-blinded prospective study on the role of propofol in pediatric anesthesia

Cheng, Dabin; Liu, Lu; Zheng, Hongbo

doi:10.12669/pjms.333.12026

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…Pain on injection is a common drug-related TEAE during propofol administration [20], and severe injection pain increases the patient's tension and anxiety and directly or indirectly affects the stability of anesthesia induction [21]. The high concentration of propofol in the aqueous phase causes the pain on injection [5].…”

Section: Discussionmentioning

confidence: 99%

Sedation Effects Produced by a Ciprofol Initial Infusion or Bolus Dose Followed by Continuous Maintenance Infusion in Healthy Subjects: A Phase 1 Trial

Teng

et al. 2021

Adv Ther

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Introduction: The effects of continuous infusions of ciprofol on its pharmacodynamic and pharmacokinetic properties and safety profiles in healthy Chinese subjects were evaluated. Methods: In this open-label, randomized, twoway cross-over study, subjects received initial doses of continuous ciprofol/propofol as an infusion for 30 min in part 1 (n = 8) and a bolus dose in part 2 (n = 8) followed by maintenance infusions for a total of 4 h in part 1 and 12 h in part 2. Each subject participated in both parts with a washout time of at least 40 h. Results: The safety and tolerability parameters of ciprofol were similar to those of propofol, and all treatment-emergent adverse events were mild. The incidences of injection pain and respiratory depression in subjects given ciprofol were lower than those receiving propofol. The pharmacokinetic parameters C max , t max , t 1/2 , kz and MRT for ciprofol and propofol were similar, while CL, V d and V ss were statistically significantly different. Pharmacodynamic parameters including the Richmond Agitation Sedation Scale and bispectral index profiles of ciprofol were similar to those of propofol. Conclusion: Ciprofol has potential for clinical application for continuous intravenous infusion to maintain sedation for 12 h with the same safety, tolerability and efficacy as propofol.

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Section: Discussionmentioning

confidence: 99%

Sedation Effects Produced by a Ciprofol Initial Infusion or Bolus Dose Followed by Continuous Maintenance Infusion in Healthy Subjects: A Phase 1 Trial

Teng

et al. 2021

Adv Ther

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“…The reported incidence of painful propofol injection varies widely, between 28% and 91% in the literature, and 38% in this current study 12,13 . 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: 75%

“…Its ability to provide a smooth induction and rapid recovery are significant advantages that have contributed to its widespread use; however, one of its significant drawbacks is pain on injection. Numerous studies have previously examined the use of medications in the reduction of pain with propofol infusion with varying degrees of efficacy 1–10 . To our knowledge, the analgesic effect of vibration on pain with propofol infusion has not previously been investigated.…”

mentioning

confidence: 99%

“…Numerous studies have previously examined the use of medications in the reduction of pain with propofol infusion with varying degrees of efficacy. [1][2][3][4][5][6][7][8][9][10] To our knowledge, the analgesic effect of vibration on pain with propofol infusion has not previously been investigated. Therefore, a randomized, single-blinded, controlled trial was conducted to explore this potential treatment modality.…”

mentioning

confidence: 99%

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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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“…A variety of anesthetics have been used to achieve pediatric epidural anesthesia, including propofol and ketamine, which have been indicated to be preferable in the clinical setting, among which propofol has been reported to exhibit a good sedative effect and a rapid working mechanism, and patients who receive propofol have been indicated to exhibit a quick recovery from anesthesia post surgery without significant adverse reactions ( 2 ). Despite its satisfactory performance in anesthesia, pain relief and sedation, ketamine administration has been indicated to result in an increased release of catechol and consequently in increased cardiovascular excitation during the recovery period; therefore, children may experience various side effects, such as nausea, vomiting, restlessness and nightmares ( 3 ). Currently, an auxiliary application of general anesthetics or sedative drugs is required in epidural anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of procaine combined with ketamine and propofol in pediatric epidural anesthesia

et al. 2020

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In the present study, the effect of procaine combined with ketamine and propofol in pediatric epidural anesthesia was analyzed. A total of 74 children scheduled to undergo surgery under epidural anesthesia were included in the study, and were divided into two groups using a random number table. Accordingly, 37 patients received epidural anesthesia using ketamine and propofol (control group), whereas the remaining patients received procaine combined with ketamine and propofol (observation group). The vital signs, sedative effects, anesthetic effects, pain intensity, anesthetic dose and incidence of adverse reactions were compared between the groups. It was revealed that the heart rate and mean arterial pressure at T4 (following epidural administration) in the observation group was significantly lower compared with those of the control group (P<0.05). However, no statistical difference was observed in the proportion of patients with sedation at Ramsay levels 1-6 between the observation and the control group (P>0.05). Compared with the control group, the observation group reported a shorter latent period for the onset of the anesthetic effect and the disappearance of pain, and a longer period for the recovery of pain sensation (P<0.05). The observation group exhibited prominently lower visual analog scale scores at 6, 12, 18 and 24 h post-surgery compared with the control group (P<0.05). Additionally, the observation group received a lower dose of ketamine and propofol compared with the control group (P<0.05). An incidence of adverse reactions of 8.11% was noted in the observation group during the surgery and anesthesia recovery period, which was lower compared with that of the control group (29.73%) (P<0.05). The results of the present study indicated that the combination of procaine with ketamine and propofol in pediatric epidural anesthesia may be more commonly employed, considering its advantages in accelerating the anesthesia process, improving the anesthetic effects and guaranteeing anesthesia safety. However, only a few indicators of the anesthesia efficacy and a small group of patients were included in the present study, and a long-term comprehensive analysis using a larger sample size is required to address this issue.

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A randomized double-blinded prospective study on the role of propofol in pediatric anesthesia

Cited by 5 publications

References 25 publications

Sedation Effects Produced by a Ciprofol Initial Infusion or Bolus Dose Followed by Continuous Maintenance Infusion in Healthy Subjects: A Phase 1 Trial

Sedation Effects Produced by a Ciprofol Initial Infusion or Bolus Dose Followed by Continuous Maintenance Infusion in Healthy Subjects: A Phase 1 Trial

The Effect of Vibration on Pain During Intravenous Injection of Propofol

Efficacy of procaine combined with ketamine and propofol in pediatric epidural anesthesia

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