Intravenous Lidocaine Alleviates the Pain of Propofol Injection by Local Anesthetic and Central Analgesic Effects

Abstract

A dosage of 40 mg lidocaine is an appropriate dosage to alleviate propofol injection pain within the same vein. Lidocaine reduces propofol injection pain through both a local anesthetic effect and a central analgesic effect when the dosage reaches 1.5 mg/kg.

Effect of Preemptive Intravenous Ibuprofen on propofol Injection Pain

“…Additionally, it is not clearly known whether pain is prevented by the local anesthetic effect of intravenous injection of lidocaine or by a systemic effect on the central nervous system. Research on this topic by Xing et al administered different doses of lidocaine and reported 40mg of lidocaine was effective in preventing propofol injection pain, with 1.5mg/kg doses of lidocaine administration preventing pain due to both local anesthetic effect and central analgesic effect [22]. In our study in the group with iv ibuprofen administered for preemptive analgesia, the pain score 0 was higher compared to the control group, but lower compared to the lidocaine group.…”

Efficacy of Pre-Treatment with Remimazolam on Prevention of Propofol-Induced Injection Pain in Patients Undergoing Abortion or Curettage: A Prospective, Double-Blinded, Randomized and Placebo-Controlled Clinical Trial

“…11 , 17 Although these strategies relieved PIP in varying degrees, the adverse event of these drugs such as emergence agitation, 18 laryngospasm, 19 pulmonary embolism, 20 gastrointestinal ulcer, 10 lengthy onset 21 or tinnitus and dizziness 22 limit their widespread clinical use. More patients complained of tinnitus or dizziness after the injection of lidocaine, 22 and the addition of lidocaine may disrupt the stability of propofol emulsions and may cause pulmonary embolism. 19 These drawbacks limited the use of lidocaine for preventing PIP.…”

Comparasion between effects of lidocaine, magnesium- sulfate and ondansetron on propofol injection pain (lidocaine, magnesium- sulfate, ondasentrone and propofol application)

“…Svaki od ispitivanih lekova pokazao je efekat na lokalni osećaj bola. Mogući mehanizam nastanka osećaja bola izazvanog propofolom je aktivacija kalikrein-kinin sistema i oslobađanje bradikinina, što rezultira venskom dilatacijom i povećanjem permeabiliteta, a sa tim i kontaktom između vodene faze propofola i slobodnih nervnih završetaka 1,20,21 . Međutim, nedavne studije pokazuju da u poređe-nju sa fiziološkim rastvorom, propofol ne podiže koncentraciju bradikinina u plazmi 1,22,23 .…”

“…Međutim, nedavne studije pokazuju da u poređe-nju sa fiziološkim rastvorom, propofol ne podiže koncentraciju bradikinina u plazmi 1,22,23 . Lidokain je primarno lokalni anestetik, koji je pronašao i sistemsku primenu 20,24 . Navodi se nekoliko mehanizama antinociceptivne aktivnosti malih doza sistemski datog lidokaina, uključujući dejstvo na C-aferentne završetke, dejstvo na dorzalne kičmene rogove, smanjenje postsinaptičke depolarizacije posredovane NMDA receptorima, kao i blokiranje centralnih i perifernih voltažno--zavisnih natrijumskih kanala na ganglionima dorzalnih korenova 20,25,26,27,28 .…”

“…Lidokain je primarno lokalni anestetik, koji je pronašao i sistemsku primenu 20,24 . Navodi se nekoliko mehanizama antinociceptivne aktivnosti malih doza sistemski datog lidokaina, uključujući dejstvo na C-aferentne završetke, dejstvo na dorzalne kičmene rogove, smanjenje postsinaptičke depolarizacije posredovane NMDA receptorima, kao i blokiranje centralnih i perifernih voltažno--zavisnih natrijumskih kanala na ganglionima dorzalnih korenova 20,25,26,27,28 . Ondansetron je poznat kao centralni antiemetik, koji deluje kao antagonista 5HT receptora.…”