Sedation with intravenous infusions of propofol or thiopentone

Wilder‐Smith, O. H. G.; Kolletzki, M.; Wilder‐Smith, Clive H.

doi:10.1111/j.1365-2044.1995.tb04560.x

Cited by 36 publications

(8 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Quite naturally, investigators studied its effects on pain perception and, just like early reports on barbiturates, noted hyperalgesic action associated with propofol both in preclinical, experimental as well as clinical studies. 12,14,16,42,43 However, despite these reports, the use of propofol as analgesic drug remained a topic of discussion. The notion that propofol was used to treat inadequate analgesia in a scientific report in 1999 44 prompted the following commentary: “Too often, in our opinion, patients receive propofol, at a time when an analgesic would serve them better.…”

Section: Discussionmentioning

confidence: 99%

Effect of Sedation on Pain Perception

Frölich

Zhang

Ness³

2013

Anesthesiology

View full text Add to dashboard Cite

Background Sedation or anesthesia is used to facilitate many cases of an estimated 45 million diagnostic and therapeutic medical procedures in the United States. Preclinical studies have called attention to the possibility that sedative hypnotic drugs can increase pain perception but it remains unclear whether this observation holds true in humans and whether pain-modulating effects are agent specific or characteristic of intravenous sedation in general. Methods To study this important clinical question, we recruited 86 healthy volunteers and randomly assigned them to receive one of three sedative drugs; midazolam, propofol or dexmedetomidine. We asked participants to rate their pain in response to four experimental pain tasks (cold, heat, ischemic or electrical pain) before and during moderate sedation. Results Midazolam increased cold, heat and electrical pain perception significantly (10-point pain rating scale change = 0.82 ± 0.29, mean ± SEM). Propofol reduced ischemic pain and dexmedetomidine reduced both cold and ischemic pain significantly (−1.58 ± 0.28, mean ± SEM). We observed a gender-by-race interaction for dexmedetomidine. In addition to these drug specific effects, we observed gender effects on pain perception; females rated identical experimental pain stimuli higher than males. We also noted racedrug interaction effects for dexmedetomidine with higher doses of drug needed to sedate Caucasians when compared to African-Americans. Conclusions The results of our study call attention to the fact that intravenous sedatives may increase pain perception. The effect of sedation on pain perception is agent and pain type specific. Knowledge of these effects provides a rational basis for analgesia and sedation to facilitate medical procedures.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Sedation on Pain Perception

Frölich

Zhang

Ness³

2013

Anesthesiology

View full text Add to dashboard Cite

show abstract

“…8 Wilder-Smith et al ., on the other hand, found no evidence for hyperalgesia in humans administered sub-hypnotic doses of propofol. 22 The reasons for these discrepancies are not clear. The high torso dose resulted in a mean peak at around 8-9 µg•ml -1 , while the lower torso dose resulted in a mean near 2 µg•ml -1 .…”

Section: Discussionmentioning

confidence: 99%

Propofol directly depresses lumbar dorsal horn neuronal responses to noxious stimulation in goats

Antognini

Wang

Piercy

et al. 2000

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Several studies [7][8][9][10][11][12] have been designed to see if hypnotics are hyperalgesic in subhypnotic doses, but results are conflicting. As propofol is one of the most widely used hypnotics in anaesthesia, and is also used for sedation in intensive care, it is important to clarify further its influence on nociception in humans.…”

mentioning

confidence: 99%

Psychophysical and electrophysiological responses to experimental pain may be influenced by sedation: comparison of the effects of a hypnotic (propofol) and an analgesic (alfentanil)

Petersen-Felix¹,

Arendt‐Nielsen²,

Bak³

et al. 1996

British Journal of Anaesthesia

View full text Add to dashboard Cite

Sedation may influence the responses of some experimental pain models used to test analgesic efficacy. In this study we compared the effects of a sedative (propofol) and analgesic (alfentanil) on: nociceptive reflex to single and repeated electrical stimulations; mechanical pressure pain; and evoked potentials elicited by nociceptive (electrical and laser) and non-nociceptive (acoustical) stimulation. We studied 12 healthy volunteers with two subanaesthetic concentrations of propofol and two analgesic concentrations of alfentanil. Both propofol and alfentanil increased the threshold for nociceptive reflex to single electrical stimulations, but only alfentanil increased the threshold for nociceptive reflex to repeated electrical stimulations. The pressure pain tolerance thresholds were increased significantly by alfentanil, whereas propofol significantly decreased the thresholds (hyperalgesia). Propofol and alfentanil induced similar reductions in the amplitudes of the evoked potentials elicited by nociceptive (electrical and laser) and non-nociceptive (acoustical) stimulation, whereas only alfentanil reduced the perceived pain to nociceptive stimulations. We have shown that sedation can influence both the psychophysical and electrophysiological responses of some experimental pain tests used to measure analgesic efficacy, and that propofol in subhypnotic doses, has no analgesic effect on painful electrical and heat stimulations, but has a hyperalgesic effect on mechanical pressure pain.

show abstract

Sedation with intravenous infusions of propofol or thiopentone

Cited by 36 publications

References 22 publications

Effect of Sedation on Pain Perception

Effect of Sedation on Pain Perception

Propofol directly depresses lumbar dorsal horn neuronal responses to noxious stimulation in goats

Psychophysical and electrophysiological responses to experimental pain may be influenced by sedation: comparison of the effects of a hypnotic (propofol) and an analgesic (alfentanil)

Contact Info

Product

Resources

About