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BJA Advance Access originally published online on May 13, 2005
British Journal of Anaesthesia 2005 95(2):222-225; doi:10.1093/bja/aei156
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org

PAEDIATRIC ANAESTHESIA

Propofol injection pain in children: a prospective randomized double-blind trial of a new propofol formulation versus propofol with added lidocaine

Y. Nyman1,*, K. von Hofsten1, A. Georgiadi2, S. Eksborg2,3 and P. A. Lönnqvist1

1 Department of Paediatric Anaesthesia and Intensive Care, Astrid Lindgrens Children's Hospital, 2 Karolinska Pharmacy, Karolinska University Hospital and Childhood Cancer Research Unit and 3 Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden

* Corresponding author. Department of Anaesthesia and Intensive Care, Astrid Lindgrens Childrens Hospital/Karolinska University Hospital, SE-171 76 Stockholm, Sweden. E-mail: yvonne.nyman{at}karolinska.se

Background. The incidence of pain on injection of propofol remains unacceptably high in children, despite various strategies to reduce it. A new drug formulation of propofol has, in adult studies, been reported to cause less injection pain compared with other propofol solutions. The aim of the present prospective randomized double-blind clinical trial was to compare the incidence of pain-free injection following the use of this new formulation with that following the use of propofol with added lidocaine in children undergoing day case surgery.

Methods. Eighty-three children (age range 2–18 yr) were randomized to receive 3 mg kg–1 of either Propofol-Lipuro® (propofol dissolved in a mixture of medium- and long-chain triglycerides [MCT–LCT]; group pL, n=42) or Diprivan® (propofol dissolved in long-chain triglycerides [LCT]) with added lidocaine (0.3 mg kg–1) (group pD, n=41). A specially trained nurse anaesthetist assessed the occurrence of injection pain using a four-graded pain scale.

Results. Significantly fewer patients had an entirely pain-free propofol injection in group pL (33.3%) than in group pD (61.0%) (P=0.016).

Conclusions. A new MCT–LCT propofol formulation as a plain solution was associated with a higher incidence of injection pain than LCT propofol with added lidocaine when used for induction of anaesthesia in children.


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Propofol and lignocaine mixture
ASHISH RAJKUMAR, et al.
British Journal of Anaesthesia, 19 Aug 2005 [Full text]

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