In children, nitrous oxide decreases pain on injection of propofol mixed with lidocaine

Abstract

P Pu ur rp po os se e: : To investigate if 50% nitrous oxide reduces the pain during injection of propofol mixed with lidocaine in children.M Me et th ho od ds s: : Healthy children undergoing iv induction of general anesthesia for elective surgery were recruited into this prospective, randomized, double-blind study. None of the patients received any premedication except for eutectic mixture of local anesthetics cream. Before induction of anesthesia with propofol 1% mixed with lidocaine 0.05% (propofol dose 3 mg·kg -1 ), the treatment group received 50% N 2 O in O 2 and the control group received 100% oxygen. Pain due to propofol administration was rated with a four-point behavioural scale: none, mild, moderate or severe.R Re es su ul lt ts s: : There were 28 subjects in the control group and 26 subjects in the treatment group. Demographic data were similar in both groups. The incidence of pain at induction was 4% after N 2 O and 36% in the control group, P < 0.01. No patients had severe pain. Most patients had mild pain. Three of the ten patients with pain in the control group had moderate pain. The number needed to treat was 3:1.C Co on nc cl lu us si io on n: : Nitrous oxide reduces pain during induction with propofol mixed with lidocaine in healthy children. ROPOFOL has many beneficial pharmacodynamic and pharmacokinetic properties. However, one of its major adverse effects is injection pain. Incidence of propofol injection pain in children varies between 28% and 85%. 1 Lidocaine is commonly mixed with propofol to reduce pain of propofol administration. This, however, does not completely remove the pain in all cases. We hypothesized that 50% N 2 O in O 2 would further reduce the pain of propofol administration in children. Objectif

Prevention of propofol-induced pain in children: pretreatment with small doses of ketamine

“…Physical and pharmacological approaches have been proposed to reduce propofol injection pain. These attempts include pretreatment or premixture of propofol with lidocaine [4,9], ketamine [3,4], thiopental sodium [10], N 2 O [11], opioid [12] , cooling [13], diluting the propofol solution [14], or changing the propofol formulation [15]. However, none of these strategies is very effective in eliminating the pain completely.…”

Propofol – A Gallery of Different Formulations and Methods to Alleviate Pain on Injection

“…Incidence of pain was 4% after nitrous oxide and 36% in control group. [32] f) Lignocaine pre-treatment-This has local anesthetic effect on vein wall. Mc Culloch et al suggested the use of 10mg lignocaine 20 seconds prior to propofol.…”

Uso do óxido nitroso em pediatria

“…Recommendation: The administration of nitrous oxide, alone or in combination with EMLA is associated with effective sedation and pain relief in children receiving injections [59][60][61] (A).…”