[Effect of pretreatment with lidocaine, intravenous paracetamol and lidocaine-fentanyl on propofol injection pain. Comparative study.
OBJECTIVE
Performed a randomized, double blind study to assess the efficacy of intravenous (IV) pretreatment with lidocaine, IV paracetamol (Perfalgan) or lidocaine mixed with fentanyl in reducing propofol injection pain.


METHODS
Immediately after venous occlusion with a rubber tourniquet on the patient's arm IV lidocaine 1% 4 mL (Group L, n = 50), IV paracetamol (Perfalgan) 4 mL (40 mg) (Group R, n = 50), lidocaine 2% mixed with 100 microg fentanyl (Group LF, n = 50) or normal saline 4 mL (Group P, n = 50; as placebo control) was given to 200 adult patients. The release of the venous occlusion was done after 60s and followed by intravenous administration of propofol 2.5 mg kg(-1) at rate of 0.5 mg s(-1) through a 20G catheter inserted in hand dorsum vein. Pain assessment was made during the propofol injection. This included movement of hand, spontaneous verbal expressions of pain, frowning, and moaning during the injection of propofol.


RESULTS
Lidocaine-fentanyl (70% pain free), and lidocaine (68% pain free) significantly reduced propofol injection pain more than paracetamol (54% pain free) and more than placebo (36% pain free) (p < 0.05). The difference in reducing the incidence of propofol injection pain between lidocaine and lidocaine-fentanyl did not reach statistical significance. There was a significant superiority of paracetamol compared to placebo (p < 0.05).


CONCLUSIONS
Propofol, a commonly used anesthetic. Given as a venous retention pretreatment 60 seconds before propofol, lidocaine and lidocaine-fentanyl were found to significantly reduce the propofol injection pain, whereas IV paracetamol (Perfalgan) slightly reduced the propofol injection pain.
El-Radaideh
Khaled M
KM
King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. elradk01@yahoo.com