[Injection pain from propofol-MCT-LCT in children. A comparison with propofol-LCT]

Abstract

Objectives: This prospective, randomised, double-blind study was designed to compare the incidence and intensity of pain on injection of propofol formulated in a mixture of medium- and long-chain triglycerides, Propofol-MCT/LCT 1% (Propofol-Lipuro, B. Braun, Germany) with propofol in a commonly used emulsion of long-chain triglycerides, Propofol-LCT 1% (Disoprivan, Zeneca) in children undergoing elective surgical procedures.

Methods: After approval of the local ethics committee 40 children, aged 7-14 years, were enrolled in the study. Premedication was with 5-10 mg diazepam orally one hour before induction of anesthesia. In the beginning 20% of the calculated dose of Propofol for induction was injected into a separate venous cannula in a dorsal vein of the hand; patients were observed for expressing pain spontaneously during injection patients or were asked to describe the sensations after 10 s. Withdrawal of the arm during injection was also noted.

Results: Significantly more children reported pain on injection of propofol-LCT compared to Propofol-MCT/LCT (25% vs, 10%) and significantly more children retracted their arm during injection of propofol-LCT (40% vs. 10%).

Implications: Propofol-MCT/LCT 1% (Propofol-Lipuro) for induction of anesthesia produced significantly less pain on injection and significantly less drawing back of the arm when compared to Propofol-LCT (Disoprivan). Thus, with respect to pain on injection Propofol-MCT/LCT appears to be superior to Propofol-LCT in children aged 7-14 years.