Lidocaine is more efficient than the choice of propofol formulations to reduce incidence of pain on induction.
OBJECTIVE
Propofol is associated with pain on injection. It is common practice to premix lidocaine with propofol prior to injection. Lipuro propofol, a propofol emulsified in medium- and long-chain triglycerides, has been shown to reduce the intensity of injection pain compared to Diprivan, although a number of studies report no reduction in overall incidence of pain.


METHODS
We conducted this randomized double-blind trial to determine the extent of further pain reduction by adding lidocaine to Lipuro propofol. A total of 328 ASA I-III patients were randomized to one of four groups to receive Diprivan propofol (Group DP), Lipuro propofol (Group LP), Diprivan with lidocaine (Group DL) and Lipuro propofol with lidocaine (Group LL). The drug mixture was administered at a constant rate of 400 mL h(-1) via a 20-G cannula into a dorsal hand vein. Pain was assessed during induction and upon patient recovery, using a 10-point visual analogue scale.


RESULTS
Both the incidence and severity of pain were found to be significantly lower with addition of lidocaine to Lipuro propofol (P < 0.0002) compared to Lipuro alone, Diprivan with or without the addition of lidocaine.


CONCLUSIONS
Lidocaine added to Lipuro propofol makes induction of anaesthesia less painful compared to Lipuro propofol alone or Diprivan with lidocaine.
Mallick
A
A
Anaesthesia and Intensive Care Unit, Leeds General Infirmary, Leeds, UK. abhiram.mallick@leedsth.mhs.uk
Elliot
S C
SC
Krishnan
K
K
Vucevic
M
M
D000328:Adult; D019162:Anesthetics, Combined / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D004311:Double-Blind Method; D004655:Emulsions; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous / Q000009:adverse effects / Q000379:methods; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D010146:Pain / Q000453:epidemiology* / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D015742:Propofol / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014280:Triglycerides / Q000008:administration & dosage
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D004655:Emulsions; D014280:Triglycerides; D008012:Lidocaine; D015742:Propofol