An admixture of 3 mg x kg(-1) of propofol and 3 mg x kg(-1) of thiopentone reduces pain on injection in pediatric anesthesia.
OBJECTIVE
To evaluate the incidence of pain on injection in children during anesthetic induction with a 3:1.2 volume admixture of 1% propofol and 2.5% thiopentone (P/T) compared to a 10:1 volume admixture of 1% propofol and 2% lidocaine (P/L).


METHODS
After Ethics Committee approval and informed written parental consent, 127 children, aged one to ten years were studied and randomized into two groups; Group P/L received an induction with 5 mg x kg(-1) of 1% propofol and 1 mg x kg(-1) of lidocaine, Group P/T with 3 mg x kg(-1) of 1% propofol and 3 mg x kg(-1) of 2.5% thiopentone in a standardized fashion. A single, blinded observer scored pain behaviour defined as a motor response of the arm, a verbal complaint of pain, cry and/or one of three standardized facial expressions of pain.


RESULTS
The incidence of pain was 14% in the P/T group, compared to 35% in the P/L group (chi(2)(1) = 7.5, P = 0.006). Motor response was the most frequent pain response in the P/L group (68%).


CONCLUSIONS
The P/T admixture is a practical and efficacious alternative to P/L for reducing pain on induction in children. Further work to evaluate the optimum proportions and possible adverse effects of this admixture should be done.
Pollard
Rachel C
RC
Department of Anesthesia, British Columbia's Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada.
Makky
Sonia
S
McFadzean
Jillian
J
Ainsworth
Laurie
L
Goobie
Susan M
SM
Montgomery
Carolyne J
CJ
D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous / Q000009:adverse effects*; D008297:Male; D010146:Pain / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage*; D016037:Single-Blind Method; D013874:Thiopental / Q000008:administration & dosage*
D018686:Anesthetics, Intravenous; D004338:Drug Combinations; D013874:Thiopental; D015742:Propofol