Venous occlusion with lidocaine for preventing propofol induced pain. A prospective double-blind randomized study.
OBJECTIVE
Pain is a well-known complication of intravenous administration of propofol, and to find out the optimal method to decrease this pain, we studied 4 methods of delivering propofol.


METHODS
The study took place at Jordan University Hospital, Amman, Jordan between November 2004 and March 2005 on 200 patients. The patients were divided into 4 groups, group I (n=50), the control group, propofol 1% was given alone. Group II (n=50), patients received propofol 1% premixed with 40 mg of lidocaine. Group III (n=50), patients received propofol 1% 60 seconds after giving 40 mg of lidocaine. Group IV (n=50), patients had venous occlusion for 60 seconds with the use of lidocaine 1% (40 mg), followed by release of the occlusion and administration of the propofol. Pain was assessed during injection and categorized into: no pain, pain, and pain with behavioral changes.


RESULTS
In group I (control), 35 patient complained of pain, compared to 26 in group II, 23 in group III, and 7 patients in group IV, with a significant reduction in the incidence and intensity of pain in group II, III, and IV compared with the control (p<0.005). The best reduction of intensity and incidence was achieved in group VI, when compared with groups I, II and III (p<0.005), with no statistical difference between group II and III when compared with each other.


CONCLUSIONS
Of the 4 methods studied, the optimal method to decrease the incidence and intensity of pain resulting from propofol injection is to inject lidocaine while applying venous occlusion for 60 seconds prior to administering propofol.
Massad
Islam M
IM
Department of General Surgery, Division of Anesthesia and Intensive Care, Jordan University Hospital, PO Box 13046, Amman 11942, Jordan. islam_wafa@yahoo.com
Abu-Ali
Hamdi M
HM
Abu-Halaweh
Sami A
SA
Badran
Izdiad Z
IZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control*; D011292:Premedication; D015742:Propofol / Q000009:adverse effects*; D011446:Prospective Studies; D014111:Tourniquets
D018686:Anesthetics, Intravenous; D004338:Drug Combinations; D008012:Lidocaine; D015742:Propofol