title: Tourniquet at 50 mm Hg followed by intravenous lidocaine diminishes hand pain associated with propofol injection.
abstract: We evaluated the efficacy of intravenous lidocaine, with and without a tourniquet, to decrease the intensity of pain during intravenous propofol injection in 82 patients undergoing general anesthesia. Patients in group A (n = 20) received propofol (2 mg/kg IV); patients in group B (n = 22) received 2% lidocaine (100 mg IV) followed 1 min later by propofol (2 mg/kg). Patients in group C (n = 21, saline placebo) and D (n = 19, 2% lidocaine) had an arm tourniquet inflated to 50 mm Hg applied for 1 min after gravity drainage of venous blood. The intensity of pain along the forearm was marked on a 0-100-mm visual analogue scale. Pain intensity was less in group B (21 +/- 19 mm) than in group A (75 +/- 28 mm; P less than 0.05). Pain intensity was significantly less in group D (1 +/- 2 mm) compared with group B (21 +/- 19 mm; P less than 0.001). We conclude that intravenous lidocaine before propofol injection attenuates the painful response; whereas, lidocaine administered after a tourniquet inflated to 50 mm Hg for 1 min virtually abolishes the pain associated with intravenous propofol.
authors.affiliation: Department of Anesthesiology, University of South Florida College of Medicine, Tampa 33612-4799.
authors.forename: D
authors.initials: D
authors.lastname: Mangar
authors.forename: E J
authors.initials: EJ
authors.lastname: Holak
mesh_terms: D000328:Adult; D004341:Drug Evaluation; D005260:Female; D006225:Hand; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control*; D010147:Pain Measurement; D011312:Pressure; D015742:Propofol / Q000009:adverse effects*; D014111:Tourniquets
chemical_list: D008012:Lidocaine; D015742:Propofol