Propofol extravasation pain masked by lignocaine premedication

Management of noncytotoxic extravasation injuries: A focused update on medications, treatment strategies, and peripheral administration of vasopressors and hypertonic saline

“…In one case, the lack of pharmacological effect following the infusion of more than 300 mg of propofol led to the suspicion of extravasation and early discontinuation of the infusion, which prevented significant or permanent injury. 93 In addition to tissue necrosis, compartment syndrome is a serious complication reported in several cases of propofol extravasation, requiring emergent fasciotomies and irrigation. [94][95][96] Although the exact mechanism of tissue injury related to propofol extravasation is unknown, tissue necrosis may be due to direct chemical irritation of skin structures, and large-volume extravasations may lead to tissue ischemia due to high hydrostatic pressures.…”

“…The rapid onset and anesthetic effects of propofol limit the ability of patients to report pain during infusion in most cases and may delay intervention. In one case, the lack of pharmacological effect following the infusion of more than 300 mg of propofol led to the suspicion of extravasation and early discontinuation of the infusion, which prevented significant or permanent injury 93 . In addition to tissue necrosis, compartment syndrome is a serious complication reported in several cases of propofol extravasation, requiring emergent fasciotomies and irrigation 94–96 …”