title: Thiopentone pretreatment for propofol injection pain in ambulatory patients.
abstract: This study investigated propofol injection pain in patients undergoing ambulatory anaesthesia. In a randomized, double-blind trial, 90 women were allocated to receive one of three treatments prior to induction of anaesthesia with propofol. Patients in Group C received 2 ml normal saline, Group L, 2 ml, lidocaine 2% (40 mg) and Group T, 2 ml thiopentone 2.5% (50 mg). Venous discomfort was assessed with a visual analogue scale (VAS) 5-15 sec after commencing propofol administration using an infusion pump (rate 1000 micrograms.kg-1.min-1). Loss of consciousness occurred in 60-90 sec. Visual analogue scores (mean +/- SD) during induction were lower in Groups L (3.3 +/- 2.5) and T (4.1 +/- 2.7) than in Group C (5.6 +/- 2.3); P = 0.0031. The incidence of venous discomfort was lower in Group L (76.6%; P < 0.05) than in Group C (100%) but not different from Group T (90%). The VAS scores for recall of pain in the recovery room were correlated with the VAS scores during induction (r = 0.7045; P < 0.0001). Recovery room discharge times were similar: C (75.9 +/- 19.4 min); L 73.6 +/- 21.6 min); T (77.1 +/- 18.9 min). Assessing their overall satisfaction, 89.7% would choose propofol anaesthesia again. We conclude that lidocaine reduces the incidence and severity of propofol injection pain in ambulatory patients whereas thiopentone only reduces its severity.
authors.affiliation: Department of Anaesthesia, Vancouver Hospital and Health Sciences Centre, University of British Columbia, Faculty of Medicine, Canada.
authors.forename: R D
authors.initials: RD
authors.lastname: Haugen
authors.forename: H
authors.initials: H
authors.lastname: Vaghadia
authors.forename: T
authors.initials: T
authors.lastname: Waters
authors.forename: P M
authors.initials: PM
authors.lastname: Merrick
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D000704:Analysis of Variance; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D000779:Anesthetics, Local; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced* / Q000517:prevention & control; D010147:Pain Measurement; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D013874:Thiopental
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008012:Lidocaine; D013874:Thiopental; D015742:Propofol