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

Abstract

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.

Efficacy of lidocaine on preventing incidence and severity of pain associated with propofol using in pediatric patients

“…In these studies, the incidence of propofol injection pain was reported in 9 of them, [17–23,25,27] and the number of patients experienced injection pain in different degrees was reported in 6 of them. [18,20–23,25] Normal saline was used as the control in 4 studies, [18,19,21,23] ketamine was used as the comparison in 2 studies, [20,25] alfentanil was used as the comparison in 3 studies, [17,18,22] and propofol lipuro (MCT/LCT) was used as the comparison in 2 studies. [19,27] The grade measuring injection pain severity was selected inconsistently, 4-point scale was chosen in 6 studies, 3-point scale was used in 2 studies, and 0–6 graded scale, FLACC Scale, and mCHEOPS were used in 1 study, respectively.…”

“…Especially, iv premedication with lidocaine injected at a dose of 2 mg/kg frequently induced bouts of coughing in infants. [21] And benign cutaneous rashes occurred in 3 pediatric patients (2 received propofol–saline and 1 received propofol lipuro [MCT/LCT]–saline). [19] And the transient severe bradycardia (heart rate fall more than 50% from the preceding value) occurred in 2 children and junctional rhythm occurred in 7 children who received the alfentanil.…”

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.…”

Prolonged seizure‐like phenomena in an English springer spaniel after total intravenous anaesthesia with propofol

“…In addition, residual neuromuscular block is a possible complication and may result in laryngeal dysfunction, increased risk of aspiration, reduction in upper airway dimensions and function, and increased incidence of postoperative hypoxaemia (Murphy and others 2008). There is some evidence that the use of lidocaine, as a pretreatment in propofol-based anaesthesia, decreases the propofol-induced motor disturbances in infants and children (Bilotta and others 2006). …”