Physicochemical Compatibility of Propofol-Lidocaine Mixture

Masaki, Yoko; Tanaka, Makoto; Nishikawa, Toshiaki

doi:10.1213/01.ane.0000087802.50796.fb

Cited by 53 publications

(30 citation statements)

References 19 publications

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“…5 Because a pulmonary embolism can be caused when the micellar diameter exceeds 4-5 lm, mixing propofol with lidocaine solution is not a clinically useful method unless the combination is used soon after mixing. 6 Jalota et al 2 recommended the routine use of small doses of opioid before induction of anesthesia despite lesser efficacy than the lidocaine-tourniquet technique. However, opioids should be administered carefully because of potential ventilation concerns for dental outpatients when intravenous conscious sedation is the intended level of sedation.…”

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confidence: 99%

Effective Dosage of Midazolam to Erase the Memory of Vascular Pain During Propofol Administration

Sato

Inoue

Hanamoto

et al. 2016

Anesthesia Progress

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Intravenous sedation with propofol is often administered to anxious patients in dental practice. Pain on injection of propofol is a common adverse effect. This study aimed to determine the age-adjusted doses of midazolam required to erase memory of vascular pain of propofol administration and assess whether the Ramsay Sedation Scale (RSS) after the pretreatment of midazolam was useful to predict amnesia of the vascular pain of propofol administration. A total of 246 patients with dental phobia requiring dental treatment under intravenous sedation were included. Patients were classified according to their age: 30s, 40s, 50s, and 60s. Three minutes after administration of a predetermined dose of midazolam, propofol was infused continuously. After completion of the dental procedure, patients were interviewed about the memory of any pain or discomfort in the injection site or forearm. The dosage of midazolam was determined using the Dixon up-down method. The first patient was administered 0.03 mg/kg, and if memory of vascular pain remained, the dosage was increased by 0.01 mg/kg for the next patient, and then if the memory was erased, the dosage was decreased by 0.01 mg/kg. The effective dosage of midazolam in 95% of each age group for erasing the memory of propofol vascular pain (ED 95 ) was determined using logistic analysis. The accuracy of RSS to predict the amnesia of injection pain was assessed by receiver operating characteristic (ROC) analysis. The ED 95 of midazolam to erase the memory of propofol vascular pain was 0.061 mg/kg in patients in their 30s, 0.049 mg/kg in patients in their 40s, 0.033 mg/kg in patients in their 50s, and 0.033 mg/kg in patients in their 60s. The area under the ROC curve was 0.31. The ED 95 of midazolam required to erase the memory of propofol vascular pain demonstrated a downward trend with age. On the other hand, it was impossible to predict the amnesia of propofol vascular pain using the RSS.

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confidence: 99%

Effective Dosage of Midazolam to Erase the Memory of Vascular Pain During Propofol Administration

Sato

Inoue

Hanamoto

et al. 2016

Anesthesia Progress

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“…Since propofol possesses the characteristics of an ideal intravenous induction agent, it is used in bolus or infusion forms in ICUs in combination with oxygen, nitrous oxide, and opioids, with the intention of sedation in general anesthesia 9,10 . Though anesthetic practices in adults are generally realized rapidly and safely using intravenous agents like propofol, mask induction of anesthesia might be preferred to avoid the adverse effects of IV induction, such as hypotension, anaphylaxis, and apnea, and also to provide comfortable inductions for patients and children who fear intravenous procedures [11][12][13][14] .…”

Section: Discussionmentioning

confidence: 99%

The Effects of Sevoflurane and Propofol on Acoustic Rhinometric Measurements

Yıldırım¹,

Özkan

Avcı³

et al. 2017

Cumhuriyet Medical Journal

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SUMMARYObjective: The aim of the study was to compare nasal mucosal vasodilation induced by two different anesthetic used to provide controlled hypotension with the aid of acoustic rhinometry (AR). Method: This study is prospective randomized clinical study. Fifty patients were randomized into propofol (Group P; n=25) and sevoflurane (Group S; n=25) groups. During anesthesia induction, Group P received propofol (2 mg kg -1 IV) and Group S was administered sevoflurane at a minimal alveolar concentration of 6-8%. Anesthesia was maintained with propofol (4 mg kg h -1 ) in Group P and 2% sevoflurane in Group S. Both groups received the analgesic remifentanil at a dose of 0.025 µg kg min -1 . Patients were performed nasal acoustic rhinometry (AR) measurements. Anesthetic doses were adjusted so as to ensure intraoperative hypotension by maintaining mean arterial pressure at 20-25% lower than the baseline value. Results: In both groups, a significant difference was detected between AR and nasal minimal cross-sectional areas (MCA) measurements taken from the patients in the supine position, both during the preoperative period and at 30 minutes after the induction of anesthesia, but a meaningful decrease in MCA1 and MCA2 values after the induction of anesthesia was observed for both groups. In addition, differences in measurements taken before and after the induction of anesthesia were greater in amplitude for the sevoflurane group versus the propofol group. Conclusions: Controlled hypotension induced using sevoflurane anesthesia might result in higher degrees of vasodilation relative to propofol anesthesia.

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“…Adding lidocaine to propofol is effective for decreasing propofol injection pain to the same degree as intravenous lidocaine [15]. The addition of lidocaine to propofol results in the coalescence of oil droplets, which finally proceeds to a visible layer [16]. Therefore, it is not recommended.…”

Section: Discussionmentioning

confidence: 99%

How to decrease pain at rapid injection of propofol: effectiveness of flurbiprofen

Nishiyama

2005

J Anesth

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Physicochemical Compatibility of Propofol-Lidocaine Mixture

Abstract: The addition of lidocaine to propofol results in time- and dose-dependent increases in oil droplet diameters in emulsion. This mixture is physicochemically unstable over time and may cause pulmonary embolism, depending on the dose of lidocaine.

Cited by 53 publications

References 19 publications

Effective Dosage of Midazolam to Erase the Memory of Vascular Pain During Propofol Administration

Effective Dosage of Midazolam to Erase the Memory of Vascular Pain During Propofol Administration

The Effects of Sevoflurane and Propofol on Acoustic Rhinometric Measurements

How to decrease pain at rapid injection of propofol: effectiveness of flurbiprofen

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