Reduction of pain on injection of propofol: combination of pretreatment of remifentanil and premixture of lidocaine with propofol

Abstract

The combination of pretreatment of remifentanil and premixture of lidocaine with propofol was more effective in reducing the incidence of pain on injection of propofol than either treatment alone.

The Effect of Lidocaine on Injection Pain of Different Propofol Concentrations in Patients Receiving Remifentanil

“…Ba şa ranoğ lu et al 8 ac hi e ved bet ter ef fi cacy with re mi fen ta nil do se of 1µg kg -1 min -1 ver sus 0.25 µg kg -1 min -1 . Ho we ver, our re sults ob ta i ned from pati ents gi ven re mi fen ta nil pret re at ment alo ne be fore pro po fol in jec ti on sup port pre vi o us re ports 8,14,15,19 sho wing that the re mi fen ta nil do es not comp le tely eli mi na te the in jec ti on pa in of pro po fol if it is used alo ne.…”

“…Kwak et al 14 re por ted that the in ci den ce of no-pa in on in jec ti on of 1% pro po fol was si mi lar (62%) in re mi fen ta nil gro up (0.35 µg.kg -1 min -1 ) and in li do ca i ne gro up. Ho wever, they fo und that 38% of pa ti ents in both re mifen ta nil and li do ca i ne gro ups suf fe red from in jec ti on pa in of pro po fol.…”

“…Opi od re cep tors are fo und cen trally in the dor sal ro ot in the cen tral ter mi nals of pri mary af fe rent ner ves and pe rip he ral sen sory ner ve fi bers and their ter mi nals. 27 Pret re at ment with re mi fen ta nil is effec ti ve in re du cing pro po fol-in du ced pa in 8,14,15 si mi lar to fin dings with fen tanyl and al fen ta nil. 7,28 Ro ehm et al 19 re por ted that re mi fen ta nil gi ven 0.25 µg kg -1 over 60 se conds be fo re pro po fol in jec ti on pro vi ded ef fec ti ve pa in re li ef com pa rab le to li doca i ne 40 mg as 70% and 67%, res pec ti vely.…”

“…14,15,18 It is known that this ver bal sco ring system is very simp le to use by the pa ti ent, and su i tab le in all pati ents du ring the ra pidly chan ging sta te of cons cio us ness du ring anest he si a in duc ti on. The ca u se of pa in on pro po fol in jec ti on is obs cu re and the re are se ve ral pro po sed mec ha nisms.…”

“…Re cently, two stu di es from Kwak et al 14 and Ao u ad et al 15 ha ve shown that the com bi na ti on tre at ment inc lu ding re mi fen ta nil and li do ca i ne comp le tely abo lis hed mo de ra te and se ve re in jec tion pa in as so ci a ted with 1% pro po fol when com pared to each drug used alo ne. Kwak et al 14 re por ted that the in ci den ce of no-pa in on in jec ti on of 1% pro po fol was si mi lar (62%) in re mi fen ta nil gro up (0.35 µg.kg -1 min -1 ) and in li do ca i ne gro up.…”