title: Prevention of propofol-induced injection pain by remifentanil: a placebo-controlled comparison with lidocaine.
abstract: In a randomised, double-blind study we compared the efficacy of continuous remifentanil infusion (0.25 microg x kg(-1) x min(-1) with 40 mg lidocaine and placebo in the prevention of injection pain due to intravenous propofol administration (1.5-2 mg x kg(-1)) in 155 patients scheduled for elective surgery. Pain severity was evaluated using a four-point scale. The incidence of injection pain was 62% in the placebo group and could be reduced significantly by using remifentanil (30%; p < 0.0015) or lidocaine (33%; p < 0.005). Analysis of the pain scores showed a significant difference between remifentanil and placebo (p < 0.00005) as well as between lidocaine and placebo (p < 0.0002). There was no significant difference between remifentanil and lidocaine. Remifentanil provided effective pain relief, comparable with lidocaine, and is an alternative as part of an intravenous anaesthesia regimen to using another concomitant drug.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Germany.
authors.forename: K D
authors.initials: KD
authors.lastname: Roehm
authors.forename: S N
authors.initials: SN
authors.lastname: Piper
authors.forename: W H
authors.initials: WH
authors.lastname: Maleck
authors.forename: J
authors.initials: J
authors.lastname: Boldt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D000779:Anesthetics, Local; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control*; D010147:Pain Measurement; D010880:Piperidines; D015742:Propofol / Q000009:adverse effects*; D000077208:Remifentanil
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D010880:Piperidines; D008012:Lidocaine; D000077208:Remifentanil; D015742:Propofol