Effect of nitrous oxide inhalation on pain after propofol and rocuronium injection

Kim, Eun-Soo; Kim, Cheul-Hong; Kim, Hae Kyu; Kwon, Jae Young; Lee, Do Won; Kim, Hee Young

doi:10.1007/s00540-013-1655-z

Cited by 11 publications

(9 citation statements)

References 19 publications

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“…[474849] Both sevoflurane and N 2 O have central analgesic effects and hence are used for labor analgesia. In the study using sevoflurane, the authors propose 3-fold action of sevoflurane in eliminating pain, namely, central mild analgesic action, sedative action, and vasodilatory action on the peripheral blood vessels.…”

Section: Remedies For Pain On Propofol Injectionmentioning

confidence: 99%

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Pain on propofol injection: Causes and remedies

DeSousa

2016

Indian J Pharmacol

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Pain on propofol injection (POPI) is a minor problem that all anesthetists face every day. Introduction of several new formulations and hundreds of clinical trials have failed to find its remedy with just one intervention in all patients. This article highlights the causes of POPI and interventions that are used to eliminate this pain in current practice. Relevant articles from Medline and Embase databases were searched and included in this descriptive review with the following conclusions: (1) POPI is due to irritation of venous adventitia leading to release of mediators such as kininogen from kinin cascade. (2) When two or more drugs or measures are used, the incidence of POPI decreases considerably. Hence, the approach to eliminating POPI should be multimodal. (3) Any regimen that includes a drug having local anesthetic effect combined with central sedative/analgesic and rapid injection into a large vein should definitely reduce the risk of POPI to negligible levels.

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Section: Remedies For Pain On Propofol Injectionmentioning

confidence: 99%

“…In a recent study by Kim et al ., pretreatment with inhaled 67% N 2 O reduced POPI as well as pain on rocuronium injection; moreover, N 2 O with or without lignocaine was superior than lignocaine alone in alleviating POPI. [47]…”

Section: Remedies For Pain On Propofol Injectionmentioning

confidence: 99%

Pain on propofol injection: Causes and remedies

DeSousa

2016

Indian J Pharmacol

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“…Thirteen studies mentioned the method of random sequence generation [11,12,13,14,15,16,17,18,19,20,21,22,23], and 10 studies used allocation concealment [11,14,23,24,25,26,27,28,29,30]. Patients were blinded in 39 studies [11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49], whereas outcome assessors were blinded in 25 studies [11,12,13,16,17,18,19,20,21,22,23,24,25,27,28,29,30,31,34,35,36,37,38,40,42].…”

Section: Resultsmentioning

confidence: 99%

“…Patients were blinded in 39 studies [11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49], whereas outcome assessors were blinded in 25 studies [11,12,13,16,17,18,19,20,21,22,23,24,25,27,28,29,30,31,34,35,36,37,38,40,42]. Seven studies presented a clear explanation for withdrawals and dropouts in each group [12,13,15,16,24,25,33] (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Pharmacological and non-pharmacological intervention for rocuronium-induced withdrawal movement in the Korean population: a meta-analysis of 41 studies including 4,742 subjects

Choi

Lee

et al. 2014

Korean J Anesthesiol

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BackgroundWe purposed to systemically review studies investigating the prophylactic effect of both pharmacological and non-pharmacological modalities against rocuronium induced withdrawal movement (RIWM) in the Korean population.MethodsLiterature search was performed using MEDLINE, EMBASE, CENTRAL, Koreamed, KMBASE, KISS and RISS up to March 2014. Randomized controlled trials (RCTs) comparing pharmacological and non-pharmacological interventions with placebo aimed for the Korean population were included. Outcome measures were the incidence and severity of RIWM. We conducted subgroup analyses according to each intervention method.ResultsData were analyzed from 41 RCTs totaling 4,742 subjects. The overall incidence of RIWM was about 80% (range 56-100%). Incidence and severity of RIWM were significantly reduced with lidocaine (risk ratio [RR] 0.60, 95% CI 0.49-0.74; standardized mean difference [SMD] -0.74, 95% CI -1.05 to -0.44), opioids (RR 0.28, 95% CI 0.18-0.44; SMD -1.71, 95% CI -2.09 to -1.34) and hypnotics (RR 0.36, 95% CI 0.25-0.52; SMD -2.20, 95% CI -2.62 to -1.79). Regardless of tourniquet use, lidocaine showed a prophylactic effect against incidence and severity of RIWM: tourniquet (RR 0.36, 95% CI 0.21-0.62; SMD -1.51, 95% CI -2.15 to -0.86); non-tourniquet (RR 0.58, 95% CI 0.47-0.71; SMD -0.74, 95% CI -1.05 to -0.44). Dilution and slow injection of rocuronium decreased incidence and severity of RIWM: dilution (RR 0.47, 95% CI 0.39-0.56; SMD -1.64, 95% CI -2.47 to -0.81); slow injection (RR 0.34, 95% CI 0.17-0.70; SMD -2.13, 95% CI -2.74 to -1.51).ConclusionsThe greater part of pharmacological and non-pharmacological interventions showed prophylactic effect against the incidence and severity of RIWM in the Korean population.

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“…101 Ketamine is also effective in children. 112 In double-blind, randomized studies in children and adults nitrous oxide in combination with oxygen was as effective as lidocaine 113,114 and the combination was more effective. 103 In double-blind, randomized, placebo-controlled studies metoclopramide, given immediately before propofol, was effective 104,105 and in most cases as effective as lidocaine; 106-110 the combination was more effective than either alone.…”

Section: Other Drugsmentioning

confidence: 99%

Management of pain during injection of propofol

Aronson¹

2014

Adverse Drug Reaction Bulletin

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The results of this narrative review and published systematic reviews suggest that to reduce the risk of pain during injection with propofol one should use a lipid emulsion of propofol, injected into a large vein, preceded by lidocaine 0.5 mg/kg with venous compression for 30-120 s. The addition of other compounds can also be recommended, and ketamine 0.4 mg/kg (adult dose) may be the additional drug of choice, particularly because the combination of ketamine and propofol (ketofol) has added therapeutic benefits. In children Emla cream is an option, but to be effective it must be applied about 4 h before propofol is injected. Dose relationStudies of the most effective dose of lidocaine have given varying results. Doses used have varied from 5 to 100 mg, in strengths varying from 0.5 to 2%. Although no dose relation has been shown in some studies, 54,55 there is evidence, as would be expected, of dose-relatedness, 56,57 a dose of around 60 mg in adults having maximum efficacy. 58

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Effect of nitrous oxide inhalation on pain after propofol and rocuronium injection

Cited by 11 publications

References 19 publications

Pain on propofol injection: Causes and remedies

Pain on propofol injection: Causes and remedies

Pharmacological and non-pharmacological intervention for rocuronium-induced withdrawal movement in the Korean population: a meta-analysis of 41 studies including 4,742 subjects

Management of pain during injection of propofol

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