The effect of the addition of lignocaine on propofol emulsion stability

Lilley, E.; Isert, P.; Carasso, Melanie L.; Kennedy, Ross A.

doi:10.1111/j.1365-2044.1996.tb12607.x

Cited by 69 publications

(39 citation statements)

References 17 publications

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“…Furthermore, propofol is prepared in a micellar state, and the micellar diameter reportedly increases with time following mixing with lidocaine solution. 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.…”

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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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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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“…Ancak, propofole lidokain ilavesi enjeksiyon ağrısını azaltmasına karşın propofol emülsiyonunun stabilizasyonunu bozabilir. (21) Doenicke ve ark. (6) 1997'de orta ve uzun zincirli yağ asitlerinden oluşan yeni propofol lipuronun enjeksiyon ağrısını azalttığını belirtmiştir.…”

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A Comparison of the Effects of Propofol and Propofol-Lipuro on Injection Pain and Hemodynamic Response

Antike¹,

Hoşten²,

Özdamar³

et al. 2011

J Turk Anaesth Int Care

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ÖZETAmaç: Propofol, anestezi indüksiyonu, idamesi ve sedasyonda sık kullanılan bir anestezik ajandır. En önemli yan etkisi enjeksiyon ağrısı ve hemodinamik yan etkileridir. Yeni bir formul olan propofol lipuro ile enjeksiyon ağrısının azaldığı belirtilmektedir. Çalışmamızda subanestezik dozda propofol ile propofol lipuronun enjeksiyon ağrısı ve hemodinamik yanıt üzerine etkileri karşılaştırılmıştır.Gereç ve Yöntem: Çalışmaya dahil edilen 150 hastanın yarısına 2 mL % 1 propofol (Grup P) diğer yarısına da 2 mL % 1 propofol lipuro (Grup PL) 1mL sn -1 hızında verildi. Beşinci sn'de ağrı skorları ve hemodinamik bulgular kaydedildi.Bulgular: Grup P'deki hastaların hepsi enjeksiyon ağrısı duyarken, Grup PL'de 17 hasta (% 22,7) hiç ağrı duymadı. Şiddetli ağrı duyan hasta sayısı Grup P'de 44 (% 58,7), Grup PL'de ise 20 (% 26,7) idi (p=0.001). Hemodinamik yanıt her iki grupta benzerdi.Sonuç: Propofol lipuro, daha az enjeksiyon ağrısına neden olması nedeniyle propofole tercih edilebilir. Anahtar kelimeler: Propofol, Propofol lipuro, ağrı SUMMARY A Comparison of the Effects of Propofol and Propofol-Lipuro on Injection Pain and Hemodynamic ResponseObjective: Propofol is an anesthetic agent used frequently for the induction and maintenance of anesthesia, and sedation as well. Its most important side effects are injection pain, and hemodynamic side-effects. There are reports stating that with a new formula (Propofol-Lipuro) injection pain is reduced. In our study the effects of sub-anesthetic dose of propofol and Propofol-Lipuro on injection pain and hemodynamic response have been compared. Material and Methods:To 75 patients included in the study, 2 mL 1 % propofol (Group P), and to another 75 cases 2 mL 1 % Propofol-Lipuro (Group PL) were administered at a rate of 1 mL s -1. Pain scores and hemodynamic findings at the postinjection 5 th secs were recorded. Results: While all the patients in Group P felt injection pain, 17 patients in Group PL (22.7 %) did not feel any pain at all (p<0.05). Severe pain was felt by 44 (58.7 %) in patients Group P, and only 20 cases (26.7 %) in Group PL (p<0.05). Hemodynamic response was similar in both groups.Conclusion: Propofol-Lipuro can be preferred over propofol due to its milder injection pain.

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“…Thus, the common practice of mixing lidocaine to propofol to reduce pain on injection should be considered carefully. 11 Picard and Tramer 12 used lidocaine (0.5 mg·kg -1 ) intravenously with a rubber tourniquet on the forearm 30 to 120 sec before propofol injection. They suggested that the "tourniquet method" is the most efficacious procedure to reduce propofol injection pain.…”

Section: Discussionmentioning

confidence: 99%

Epidural anesthesia with lidocaine reduces propofol injection pain

Yoshikawa

Wajima

Inoue

et al. 2001

Can J Anesth/J Can Anesth

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Purpose: To determine whether epidural lidocaine reduces the severity of propofol injection pain compared with iv lidocaine.Methods: A prospective, randomized double-blind clinical study was conducted in 120 female patients scheduled for elective gynecological laparotomy. A lumbar epidural catheter and an iv catheter placed in the cephalic vein of the non-dominant hand were used in all patients. Patients of the control group (Group C) were given epidural normal saline followed by iv normal saline then iv propofol. Patients of Group E were given epidural 2% lidocaine (0.08 mL·cm -1 ) followed by iv normal saline and then propofol. Patients of Group V were given epidural normal saline followed by iv 2% lidocaine (0.05 mL·kg -1 ) then propofol. Pain was scored as no pain=0, minimal pain=1, moderate pain=2, severe pain=3.Results: The pain scores, in group E; 1 (0-2) and group V; 2 (0-2), were significantly lower than in group C; 2 (1-3); median (25 th -75 th percentile) (P <0.001). There was no difference in pain score between groups E and V. The plasma lidocaine concentration 15 min after epidural lidocaine was 2.74 ± 0.54 µg·mL -1 , compared with 1.54 ± 0.31 µg·mL -1 at three minutes after iv lidocaine.Conclusion: Epidural and iv lidocaine equally reduced the severity of propofol injection pain despite higher lidocaine plasma concentrations in epidurally administered lidocaine. Objectif : Déterminer si la lidocaïne, en injection péridurale comparée à l'injection iv, peut réduire la douleur causée par l'administration de propofol.

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The effect of the addition of lignocaine on propofol emulsion stability

Abstract: Summary

Cited by 69 publications

References 17 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

A Comparison of the Effects of Propofol and Propofol-Lipuro on Injection Pain and Hemodynamic Response

Epidural anesthesia with lidocaine reduces propofol injection pain

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