title: Propofol injection pain in children: a prospective randomized double-blind trial of a new propofol formulation versus propofol with added lidocaine.
abstract: 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.
authors.affiliation: Department of Paediatric Anaesthesia and Intensive Care, Astrid Lindgrens Children's Hospital, Karolinska Institutet, Stockholm, Sweden. yvonne.nyman@karolinska.se
authors.forename: Y
authors.initials: Y
authors.lastname: Nyman
authors.forename: K
authors.initials: K
authors.lastname: von Hofsten
authors.forename: A
authors.initials: A
authors.lastname: Georgiadi
authors.forename: S
authors.initials: S
authors.lastname: Eksborg
authors.forename: P A
authors.initials: PA
authors.lastname: Lönnqvist
mesh_terms: 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
chemical_list: D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D008012:Lidocaine; D015742:Propofol