Prevention of propofol-induced pain in children: combination of alfentanil and lidocaine vs alfentanil or lidocaine alone.
BACKGROUND
Pain from a propofol injection is a common side-effect in paediatric patients. This prospective, randomized, double-blind study evaluated the efficacy of a combined pretreatment of alfentanil with lidocaine on the incidence and severity of propofol injection pain in children.


METHODS
After obtaining parental consent, 120 paediatric patients were allocated randomly into one of the three groups (n=40, in each). The patients in the alfentanil group received alfentanil 15 microg kg(-1) 90 s before the propofol injection. The patients in the lidocaine group received propofol 3 mg kg(-1) premixed with lidocaine 0.1% over a 15 s period. The patients in the combination group received both alfentanil and lidocaine.


RESULTS
The incidence of propofol injection pain (severity 2 or more) in the combination group (2.6%) was significantly lower than that in the alfentanil and lidocaine groups (30% and 38.5%, respectively) (P=0.001 and <0.001, respectively). No patient in the combination group complained of moderate or severe pain from propofol injection.


CONCLUSIONS
Our study demonstrated that the combination treatment of two different analgesic modalities, alfentanil and lidocaine, could prevent the moderate and severe pain on propofol injection, and reduce the incidence of mild pain compared with each drug alone.
Kwak
H J
HJ
Department of Anaesthesiology and Pain Medicine, Gachon University of Medicine and Science, Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon 405-760, Korea.
Min
S K
SK
Kim
J S
JS
Kim
J Y
JY
D015760:Alfentanil / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control*; D015742:Propofol / Q000009:adverse effects*; D011446:Prospective Studies
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D015760:Alfentanil; D008012:Lidocaine; D015742:Propofol