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BJA Advance Access published online on June 19, 2009
British Journal of Anaesthesia, doi:10.1093/bja/aep163
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Prevention of propofol-induced pain in children: combination of alfentanil and lidocaine vs alfentanil or lidocaine alone

H. J. Kwak1, S. K. Min2, J. S. Kim2 and J. Y. Kim2,*

1 Department of Anaesthesiology and Pain Medicine, Gachon University of Medicine and Science, Gil Medical Center, 1198, Guwol-dong, Namdong-gu, Incheon 405-760, Korea
2 Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon 443-721, Korea

* Corresponding author. E-mail: kjyeop{at}ajou.ac.kr

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 µg 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.

Keywords: anaesthesia, paediatric; anaesthetics i.v., propofol; anaesthetics local, lidocaine; analgesics opioid, alfentanil; pain, injection


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