[Effectiveness of local cooling and lidocaine administration for prevention of pain upon injection of propofol].

BACKGROUND

Propofol is commonly used for induction and maintenance of anesthesia, but pain at the site of intravenous injection is a clinical problem. We studied the effectiveness of local cooling and pretreatment with lidocaine for prevention of injection pain of propofol.

METHODS

A total of 226 adult patients scheduled to receive general anesthesia were assigned randomly to four groups: a control group receiving no prophylactic intervention, a cooling group receiving topical cooling, a lidocaine group receiving 1 mg x kg(-1) lidocaine, and a lidocaine plus cooling group receiving topical cooling and 1 mg x kg(-1) lidocaine. A 20 gauge intravenous catheter was inserted into the peripheral vein at the radial side of the forearm. After prophylactic intervention had been performed, 1-2 mg x kg(-1) MCT/LCT propofol was injected. Patients were asked to grade the pain as none, mild, moderate, or severe.

RESULTS

The incidence of propofol-induced pain was significantly higher in the control group (39%) than in the other three groups (17% in the cooling group, 16% in the lidocaine group and 8% in the lidocaine plus cooling group). However, there were no significant differences between the three groups with different prophylactic interventions.

CONCLUSIONS

The results suggest that cooling and pretreatment with lidocaine reduce the incidence of pain upon propofol injection.