[Prevention of pain on injection with propofol in children: comparison of nitrous oxide with lidocaine].
BACKGROUND
Injection pain caused by propofol is an important disadvantage, especially in children, incompletely reduced by adding lidocaine intravenously. Nitrous oxide's analgesic effects, well known, have never been evaluated on pain due to propofol.


OBJECTIVE
To compare the effects of nitrous oxide with lidocaine on pain on injection caused by propofol in children.


METHODS
Double blind, randomised, prospective study.


METHODS
48 children aged more than 5 were randomly allocated to one of the 2 groups: N2O group, breathed 50% N2O + 50% O2 than received propofol only and Lido group breathed 100% O2 and received a mixture of propofol with lidocaine. The possible pain was scored during injection by a behavioural scale and once again in the recovery room by the child himself with a VAS.


RESULTS
There was no significant difference in behavioural pain scores among the 2 groups; pain was assessed as being moderate or severe in 6/24 patients in N2O group and 10/24 in Lido group (behavioural scores > 1). Significantly more children in the N2O group had low VAS scores compared with the Lido group (no child/24 scored a VAS > 4 and 7/23 in the Lido group) demonstrating that N2O amnesic effects would omit the memory of pain caused by propofol.


CONCLUSIONS
The use of nitrous oxide is an easy, cheap and efficient method to reduce the incidence of pain injection of propofol and his amnesic effects can provide real advantages in paediatric anaesthesia.
Lembert
N
N
Service d'anesthésie-réanimation chirurgicale 2, centre hospitalier et universitaire de Ponchaillou, université de Rennes I, 35033 Rennes, France.
Wodey
E
E
Geslot
D
D
Ecoffey
C
C
D000700:Analgesics / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007267:Injections / Q000009:adverse effects*; D008012:Lidocaine / Q000627:therapeutic use*; D009609:Nitrous Oxide / Q000627:therapeutic use*; D010146:Pain / Q000139:chemically induced* / Q000517:prevention & control; D010147:Pain Measurement; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects
D000700:Analgesics; D006993:Hypnotics and Sedatives; D008012:Lidocaine; D009609:Nitrous Oxide; D015742:Propofol