In children, nitrous oxide decreases pain on injection of propofol mixed with lidocaine.
OBJECTIVE
To investigate if 50% nitrous oxide reduces the pain during injection of propofol mixed with lidocaine in children.


METHODS
Healthy children undergoing iv induction of general anesthesia for elective surgery were recruited into this prospective, randomized, double-blind study. None of the patients received any premedication except for eutectic mixture of local anesthetics cream. Before induction of anesthesia with propofol 1% mixed with lidocaine 0.05% (propofol dose 3 mg x kg(-1)), the treatment group received 50% N(2)O in O(2) and the control group received 100% oxygen. Pain due to propofol administration was rated with a four-point behavioural scale: none, mild, moderate or severe.


RESULTS
There were 28 subjects in the control group and 26 subjects in the treatment group. Demographic data were similar in both groups. The incidence of pain at induction was 4% after N(2)O and 36% in the control group, P < 0.01. No patients had severe pain. Most patients had mild pain. Three of the ten patients with pain in the control group had moderate pain. The number needed to treat was 3:1.


CONCLUSIONS
Nitrous oxide reduces pain during induction with propofol mixed with lidocaine in healthy children.
Beh
Terence
T
Department of Anaesthetics, Monash Medical Centre, Clayton, Victoria, Australia. t.beh@southernhealth.org.au
Splinter
William
W
Kim
Jarmila
J
D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D009609:Nitrous Oxide / Q000627:therapeutic use*; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies
D018686:Anesthetics, Intravenous; D008012:Lidocaine; D009609:Nitrous Oxide; D015742:Propofol