Epidural anesthesia with lidocaine reduces propofol injection pain.
OBJECTIVE
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 (25th-75th 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 microg.ml(-1), compared with 1.54 +/- 0.31 microg.mL(-1) at three minutes after iv lidocaine.


CONCLUSIONS
Epidural and iv lidocaine equally reduced the severity of propofol injection pain despite higher lidocaine plasma concentrations in epidurally administered lidocaine.
Yoshikawa
T
T
Department of Anaesthesia, Hakujikai Memorial Hospital, Tokyo, Japan. FZN03121@nifty.ne.jp
Wajima
Z
Z
Inoue
T
T
Ogura
A
A
Ogawa
R
R
D000328:Adult; D000767:Anesthesia, Epidural; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local / Q000493:pharmacokinetics; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007813:Laparotomy; D008012:Lidocaine / Q000493:pharmacokinetics; D008297:Male; D010146:Pain / Q000517:prevention & control*; D015742:Propofol; D011446:Prospective Studies
D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008012:Lidocaine; D015742:Propofol