A combination of lidocaine (lignocaine) and remifentanil reduces pain during propofol injection.
OBJECTIVE
Pain on injection is a well known adverse effect of propofol. The purpose of this study was to compare the analgesic effect of a lidocaine (lignocaine)/remifentanil combination compared with either lidocaine alone or remifentanil alone during propofol injection for induction of anaesthesia.


METHODS
In a randomised, double-blind, prospective trial, 129 patients were allocated to one of three groups (each n = 43) receiving lidocaine 20mg, remifentanil 0.3 microg/kg or lidocaine 20 mg plus remifentanil 0.3 microg/kg as pretreatment, followed by injection of 5 mL of 1% propofol. Pain severity was evaluated on a four-point scale.


RESULTS
Two patients (4.7%) complained of pain in the lidocaine plus remifentanil group compared with 15 (35.7%) in the lidocaine alone group and 18 (42.9%) in the remifentanil alone group (p < 0.001). There was no significant difference in the incidence of injection pain between the lidocaine alone and remifentanil alone groups (p = 0.21).


CONCLUSIONS
Pretreatment with a combination of lidocaine and remifentanil is more effective than either pretreatment alone in reducing pain on injection of propofol.
Kwak
Kyunghwa
K
Department of Anesthesiology, School of Medicine, Kyungpook National University, Daegu, Korea.
Chung
Hoyun
H
Lim
Choonhak
C
Han
Changgyu
C
Choi
Gwangwook
G
Lim
Donggun
D
Kim
Sioh
S
Jeon
Younghoon
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control*; D010880:Piperidines / Q000627:therapeutic use*; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D012018:Reflex / Q000187:drug effects; D000077208:Remifentanil
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D010880:Piperidines; D008012:Lidocaine; D000077208:Remifentanil; D015742:Propofol