Propofol injection pain in children: a prospective randomized double-blind trial of a new propofol formulation versus propofol with added lidocaine.
BACKGROUND
The incidence of pain on injection of propofol remains unacceptably high in children, despite various strategies to reduce it. A new drug formulation of propofol has, in adult studies, been reported to cause less injection pain compared with other propofol solutions. The aim of the present prospective randomized double-blind clinical trial was to compare the incidence of pain-free injection following the use of this new formulation with that following the use of propofol with added lidocaine in children undergoing day case surgery.


METHODS
Eighty-three children (age range 2-18 yr) were randomized to receive 3 mg kg(-1) of either Propofol-Lipuro (propofol dissolved in a mixture of medium- and long-chain triglycerides [MCT-LCT]; group pL, n=42) or Diprivan (propofol dissolved in long-chain triglycerides [LCT]) with added lidocaine (0.3 mg kg(-1)) (group pD, n=41). A specially trained nurse anaesthetist assessed the occurrence of injection pain using a four-graded pain scale.


RESULTS
Significantly fewer patients had an entirely pain-free propofol injection in group pL (33.3%) than in group pD (61.0%) (P=0.016).


CONCLUSIONS
A new MCT-LCT propofol formulation as a plain solution was associated with a higher incidence of injection pain than LCT propofol with added lidocaine when used for induction of anaesthesia in children.
Nyman
Y
Y
Department of Paediatric Anaesthesia and Intensive Care, Astrid Lindgrens Children's Hospital, Karolinska Institutet, Stockholm, Sweden. yvonne.nyman@karolinska.se
von Hofsten
K
K
Georgiadi
A
A
Eksborg
S
S
Lönnqvist
P A
PA
D000293:Adolescent; D019162:Anesthetics, Combined / Q000494:pharmacology*; 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; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D015742:Propofol / Q000008:administration & dosage*; D012737:Sex Factors
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D008012:Lidocaine; D015742:Propofol