Injection Pain of Propofol in Children With Medium Plus Long Chain Triglycerides and Long Chain Propofol Mixed With Lignocaine

Abstract

Introduction: Propofol is widely accepted drug because of its rapid and smooth induction, short context-sensitive time, rapid terminal half-life time and low incidence of postoperative nausea and vomiting. It is used for sedation and anaesthesia for almost all types of surgeries. 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. Despite various strategies to reduce propofol injection pain, this still poses a clinical problem in adults and children, and the incidence reported to be 30–90%. A medium-chain triglyceride/long-chain triglyceride (MCT/LCT) emulsion has been advised to reduce injection pain as compared to propofol LCT in adults and teenagers
 Material and Methods: 100 children aged 5–13 years, in American Society Anaesthesiologists (ASA) class I or II, undergoing elective general anaesthesia without any contraindication to propofol anaesthesia were included in the study. Injection pain following injection propofol was assessed in all patients, but the anaesthetist was blinded for which formula was being used.
 Results: The demographic characteristics like age, sex, weight, amount of propofol given, ASA physical status and recovery period was calculated. No statistically significant difference was observed in both the groups. Incidence of pain and severe pain in LCT group was 24 (48%) and 7 (14%) respectively while incidence of pain and severe pain in MCT/LCT group was 15 (30%) and 1 (2%) respectively. Pain score was found less in group MCT / LCT.
 Conclusion: Medium plus long chain triglycerides and long chain propofol along with lignocaine significantly reduces the incidence as well as the severity of injection pain in the paediatric age group and can be used in children for sedation or induction of anaesthesia.