Are children just little adults when it comes to propofol injection pain?

Cox, Robin G.

doi:10.1007/bf03017894

Cited by 8 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[1] However, during a propofol injection, pain due to the long-chain triglyceride (LCT) emulsion is experienced by 70% of adults and up to 85% of children. [2–4] Despite various strategies to reduce propofol injection pain, this still represents a clinical problem in adults and children, with reported incidence of 30–90%.…”

Section: Introductionmentioning

confidence: 99%

Injection pain of propofol in children: A comparison of two formulations without added lidocaine

Beyaz¹,

Eman²

2012

J Anaesthesiol Clin Pharmacol

View full text Add to dashboard Cite

Background:Propofol emulsion in medium and long-chain triglycerides (MCT/LCT) has been reported to cause less injection pain than other propofol solutions in adult studies. The aim of this study was to compare the injection pain of two different propofol emulsions using two different pain scales on the pediatric population.Materials and Methods:100 children scheduled for general anesthesia were divided into two groups. Patients were randomly assigned to receive propofol LCT or propofol MCT/LCT. Assessment and evaluation of the Ontario Children's Hospital Pain Scale (mCHEOPS) and the Wong-Baker Faces Scale (WBFS) were performed at the start of the injection until the patients lose consciousness.Results:There were no significant differences between groups in terms of demographic data. According to the mCHEOPS scale, the pain incidence of propofol LCT was 5%, whereas for propofol MCT/LCT it was 15% (P < 0.05). According to the WBFS Pain Scale, the pain incidence of propofol LCT was 17%, whereas for propofol MCT/LCT it was 21% (P > 0.05).Conclusions:Propofol MCT/LCT does not decrease injection pain; contrary to the general assumption, it causes more pain than propofol LCT in children.

show abstract

Section: Introductionmentioning

confidence: 99%

Injection pain of propofol in children: A comparison of two formulations without added lidocaine

Beyaz¹,

Eman²

2012

J Anaesthesiol Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…To minimize pain and distress in children and parents alike, those undergoing painful diagnostic or therapeutic procedures are usually sedated with propofol, because it provides rapid induction and recovery from anesthesia (4,5). Nevertheless, propofol injection during induction of anesthesia induces adverse reactions including injection site pain in up to 85% of children (6,7). Although numerous studies recommend the use of various drugs (lidocaine, thiopental, midazolam, fentanyl, ketamine and beta‐blockers) before propofol injection (4–7), none of these techniques for preventing pain at the injection site (8–12) has gained wide clinical acceptance.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, propofol injection during induction of anesthesia induces adverse reactions including injection site pain in up to 85% of children (6,7). Although numerous studies recommend the use of various drugs (lidocaine, thiopental, midazolam, fentanyl, ketamine and beta‐blockers) before propofol injection (4–7), none of these techniques for preventing pain at the injection site (8–12) has gained wide clinical acceptance. In children receiving propofol (3 mg·kg −1 ) and in up to 26% of adult subgroups, propofol injection during anesthesia induction also causes transient neurological events with motor disturbances (13–15).…”

Section: Introductionmentioning

confidence: 99%

Lidocaine pretreatment for the prevention of propofol‐induced transient motor disturbances in children during anesthesia induction: a randomized controlled trial in children undergoing invasive hematologic procedures

Bilotta

Ferri

Soriano

et al. 2006

Pediatric Anesthesia

View full text Add to dashboard Cite

Because lidocaine pretreatment before the induction of propofol-based anesthesia decreases propofol-induced motor disturbances, lowers hypnotic requirements and reduces pain at the injection site, without inducing untoward events, thus improving children's and parental acceptance, it should become standard practice in infants and children undergoing repeated painful diagnostic and therapeutic hematological procedures.

show abstract

“…aufgrund der atemdepressiven Wirkung nicht erwünscht ist, bietet die von Agarwal et al[45] empfohlene Vorinjektion einer subanästhetischen Thiopentaldosis (0,5 mg/kg) aus unserer Sicht eine Alternative. Mischungen hypnotischer Thiopentaldosen mit Propofol haben möglicher-weise Einfluss auf die Aufwachphase und scheinen damit weniger geeignet für die Kurzzeitsedierung[85].Antiemetika mit lokalanästhetischen Eigenschaften können zur Injektionsschmerzprävention eingesetzt werden, wenn eine medikamentöse Prophylaxe von Übelkeit und Erbrechen geplant ist.Für die Kinderanästhesie bietet sich der Einsatz von EMLACreme als Komponente im Rahmen der Propofolschmerzpräven-tion an, da hierdurch gleichzeitig die Toleranz der Venenpunktion ermöglicht wird[86,87]. Allerdings ist die Anwendbarkeit bei Notfall-Eingriffen aus Zeitgründen limitiert und die Wirksamkeit von EMLA zur Injektionsschmerzprophylaxe mit kontrollierten Studien bisher nicht bewiesen.Picard et al [4], die bei nicht prämedizierten, 3 ± 10 Jahre alten Kindern im Rahmen ihrer Untersuchungen 60 min präoperativ EMLA-Creme applizierten und vor der Narkoseeinleitung mit Propofol eine Dosis von 20 g/kg Alfentanil i. v. injizierten, beobachteten bei keinem Patienten Anzeichen für das Auftreten von Injektionsschmerzen.…”

unclassified

Injektionsschmerzen nach Propofolgabe

Auerswald¹,

Pfeiffer²,

Behrends³

et al. 2005

Anasthesiol Intensivmed Notfal

View full text Add to dashboard Cite

Injection-induced pain during induction of anaesthesia can result in patient's discomfort. This can prevent the use of propofol-anaesthesia in paediatric patients. Because of the high incidence of pain on injection with propofol numerous interventions have been tested to prevent this pain including the use of different drugs and physical measures as well as the combination of methods. The use of a single intervention is not as effective as the combination of different preventive measures. Thus the additional application of a venous tourniquet improves the pain reducing effect if drugs with peripheral mechanism of action are used for prevention of pain. Injection of lidocaine with a rubber tourniquet before the propofol injection is recommended as best effective method. In any case a propofol-MCT/LCT-Emulsion should be used for propofol-anaesthesia. Additionally a multimodal strategy that is adapted to the daily clinical practice seems to be convenient. That means, for general anaesthesia opioids or ketamine and for sedation a sub-anaesthetic dose of thiopental can be used for effective prevention of pain. If the prevention of nausea and emesis is intended, antiemetics that are appropriate for prevention of injection pain should be given. For paediatric anaesthesia the application of EMLA-cream seems to be suitable, because it alleviates the pain during venous cannulation at the same time. Although a painfree propofol injection is not possible with every prevention strategy there exist a wide range of effective interventions to prevent pain on injection with propofol. This article reviews methods that have been investigated and established to minimise the incidence of pain.

show abstract

Are children just little adults when it comes to propofol injection pain?

Cited by 8 publications

References 10 publications

Injection pain of propofol in children: A comparison of two formulations without added lidocaine

Injection pain of propofol in children: A comparison of two formulations without added lidocaine

Lidocaine pretreatment for the prevention of propofol‐induced transient motor disturbances in children during anesthesia induction: a randomized controlled trial in children undergoing invasive hematologic procedures

Injektionsschmerzen nach Propofolgabe

Contact Info

Product

Resources

About