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Electronic Letters to:

Paediatric Anaesthesia:
Y. Nyman, K. von Hofsten, A. Georgiadi, S. Eksborg, and P. A. Lönnqvist
Propofol injection pain in children: a prospective randomized double-blind trial of a new propofol formulation versus propofol with added lidocaine
Br. J. Anaesth. 2005; 95: 222-225 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read E-letter] Propofol and lignocaine mixture
ASHISH RAJKUMAR, O.J.Hill, Consultant Anaesthetist   (19 August 2005)

Propofol and lignocaine mixture 19 August 2005
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ASHISH RAJKUMAR,
Anaesthetic trainee
south manchester university hospital NHS,
O.J.Hill, Consultant Anaesthetist

Send letter to journal:
Re: Propofol and lignocaine mixture

Editor - We read with interest the article by Nyman and colleagues(1).On contacting AstraZeneca UK division, we were told that propofol and lignocaine mixture is not stable for more that 1 hour at 23oC(2). Studies suggest emulsion instability following the addition of lignocaine to propofol. A rapid increase in the emulsion droplet diameter when above doses 10mg lidocaine are added to 200mg of propofol especially after storage at room temperature(3). Authors do not comment on the time between use and mixing of the Diprivan® with lidocaine but this change in physical properties of the emulsion may have some influence on the results of the study. Why was four point pain scale (1-4) abandoned and not used in the analysis of results? In the results, authors mention “pain free (pain score=0)” while their scoring system runs 1-4. Presumably this is a printing error and should read “pain score = 1’.

A.Rajkumar O.J.Hill Manchester, UK. Email: ashish_rj@yahoo.co.uk

References

1. Y. Nyman, K. von Hofsten, A. Georgiad, S. Eksborg and P. A. Lönnqvist Propofol injection pain in children: a prospective randomized double-blind trial of a new propofol formulation versus propofol with added lidocaine. Br J Anaesthesia 2005; 95: 222–5

2. Trissel L.A. In: Handbook of injectable drugs, 13th Ed. American Society of Health System Pharmacist,2005; 1279.

3. Lilley EMM, Isert PR, Carasso ML, Kennedy RA. The effect of the addition of lignocaine on propofol emulsion stability.Anaesthesia 1996; 51: 815–8.

Conflict of Interest:

None declared