title: Comparison of intravenous retention of fentanyl and lidocaine on local analgesia in propofol injection pain.
abstract: BACKGROUND
  With a tourniquet on arm for arresting venous blood flow, we evaluated the efficacy of intravenous (i.v.) retention of fentanyl and lidocaine in reducing the pain on i.v. propofol injection during general anesthesia.
  
  
  METHODS
  One hundred and twelve patients were studied. Following a venous occlusion by a tourniquet inflated to 70 mmHg, patients in Group A (n = 38) received normal saline (NS) 3 ml, while those in Group B (n = 37) and in Group C (n = 37) respectively received fentanyl 150 micrograms or 3 ml and 2% lidocaine 3 ml (60 mg). The venous retention of drug was maintained for 1 min, followed immediately by tourniquet release and propofol 100 mg i.v. injection over 20 s.
  
  
  RESULTS
  Both fentanyl and lidocaine treatments (Groups B and C) were significantly better than placebo (Group A) in reducing pain on propofol injection (p < 0.005). Lidocaine 60 mg was more effective than fentanyl 150 micrograms in reduction of pain associated with i.v. propofol (p < 0.001). Injection of fentanyl itself caused pain in 28% of patients as compared to 2% in the lidocaine group. Mild local skin erythema was noted in 14% of patients with fentanyl venous retention versus 0% of patients with lidocaine venous retention.
  
  
  CONCLUSIONS
  Intravenous retention of fentanyl 150 micrograms, although less effective than that of lidocaine (p < 0.001), showed local analgesic effect in reducing the pain on propofol injection. The hypothetic mechanisms of action were speculated.
authors.affiliation: Department of Anesthesia, Show-Chwan Memorial Hospital, Changhua, Taiwan, R.O.C.
authors.forename: W W
authors.initials: WW
authors.lastname: Pang
authors.forename: S
authors.initials: S
authors.lastname: Huang
authors.forename: Y T
authors.initials: YT
authors.lastname: Chung
authors.forename: D P
authors.initials: DP
authors.lastname: Chang
authors.forename: S S
authors.initials: SS
authors.lastname: Lin
authors.forename: M H
authors.initials: MH
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000698:Analgesia; D000701:Analgesics, Opioid / Q000493:pharmacokinetics*; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000493:pharmacokinetics*; D005260:Female; D005283:Fentanyl / Q000493:pharmacokinetics*; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects*; D008012:Lidocaine / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D015742:Propofol / Q000009:adverse effects*
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008012:Lidocaine; D005283:Fentanyl; D015742:Propofol