Pain reduction on injection of microemulsion propofol via combination of remifentanil and lidocaine
- PMID: 20532050
- PMCID: PMC2881517
- DOI: 10.4097/kjae.2010.58.5.435
Pain reduction on injection of microemulsion propofol via combination of remifentanil and lidocaine
Abstract
Background: Microemulsion propofol produces more frequent and severe pain upon injection than lipid emulsion propofol. This study examined the analgesic effect of lidocaine-premixed microemulsion propofol in patients pretreated with remifentanil. The induction of anesthesia with this combination was compared with microemulsion propofol accompanied with either remifentanil or lidocaine.
Methods: One hundred twenty patients aged between 20-65 years old were allocated randomly into one of three groups (n = 40, in each). The patients in the remifentanil group received remifentanil 0.5 microg/kg IV for 30 seconds before a microemulsion propofol injection. The patients in the lidocaine group received propofol 2 mg/kg premixed with 40 mg lidocaine over a 60 second period. The patients in the combination group received both remifentanil and lidocaine.
Results: There was a significantly lower incidence of microemulsion propofol injection pain (severity 2 or more) in the combination group (12.5%) than in the remifentanil and lidocaine groups (90% and 65%, respectively, P < 0.05). The incidence of moderate pain disappeared completely in the combination group (0%) compared to that in the remifentanil and lidocaine group (32.5% and 20%, respectively, P < 0.05). Severe pain did not appear in any of the three groups. There were no complications on the injection site in the lidocaine alone and combination groups.
Conclusions: The combination of microemulsion propofol premixed with lidocaine after a pretreatment with remifentanil was more effective in reducing the incidence of pain upon the injection of microemulsion propofol than either treatment alone.
Keywords: Intravenous anesthetics; Lidocaine; Microemulsion propofol; Pain; Remifentanil.
Figures

Similar articles
-
The effect of priming injection of different doses of remifentanil on injection pain of microemulsion propofol premixed with lidocaine.Korean J Anesthesiol. 2011 Feb;60(2):78-82. doi: 10.4097/kjae.2011.60.2.78. Epub 2011 Feb 25. Korean J Anesthesiol. 2011. PMID: 21390161 Free PMC article.
-
Multimodal analgesia to prevent propofol-induced pain: pretreatment with remifentanil and lidocaine versus remifentanil or lidocaine alone.Anesth Analg. 2007 Jun;104(6):1540-4, table of contents. doi: 10.1213/01.ane.0000261520.34879.09. Anesth Analg. 2007. PMID: 17513655 Clinical Trial.
-
Reduction of pain on injection of propofol: combination of pretreatment of remifentanil and premixture of lidocaine with propofol.Eur J Anaesthesiol. 2007 Sep;24(9):746-50. doi: 10.1017/S026502150600233X. Epub 2007 Jan 30. Eur J Anaesthesiol. 2007. PMID: 17261216 Clinical Trial.
-
A combination of lidocaine (lignocaine) and remifentanil reduces pain during propofol injection.Clin Drug Investig. 2007;27(7):493-7. doi: 10.2165/00044011-200727070-00006. Clin Drug Investig. 2007. PMID: 17563129 Clinical Trial.
-
Prevention of pain with the injection of microemulsion propofol: a comparison of a combination of lidocaine and ketamine with lidocaine or ketamine alone.Korean J Anesthesiol. 2010 Oct;59(4):233-7. doi: 10.4097/kjae.2010.59.4.233. Epub 2010 Oct 21. Korean J Anesthesiol. 2010. PMID: 21057611 Free PMC article.
Cited by
-
Evaluation of the Effect of Propofol-Remifentanil and Propofol-Hydralazine on the Bleeding Volume During Dacryocystorhinostomy Surgery Under General Anesthesia.Adv Biomed Res. 2023 Aug 31;12:207. doi: 10.4103/abr.abr_57_22. eCollection 2023. Adv Biomed Res. 2023. PMID: 38073730 Free PMC article.
-
Prevention of microemulsion propofol injection pain: a comparison of a combination of lidocaine and ramosetron with lidocaine or ramosetron alone.Korean J Anesthesiol. 2011 Jul;61(1):30-4. doi: 10.4097/kjae.2011.61.1.30. Epub 2011 Jul 21. Korean J Anesthesiol. 2011. PMID: 21860748 Free PMC article.
-
Synthesis and evaluation of hydroponically alginate nanoparticles as novel carrier for intravenous delivery of propofol.J Mater Sci Mater Med. 2015 Mar;26(3):145. doi: 10.1007/s10856-015-5452-0. Epub 2015 Mar 6. J Mater Sci Mater Med. 2015. PMID: 25743747
-
The effect of priming injection of different doses of remifentanil on injection pain of microemulsion propofol premixed with lidocaine.Korean J Anesthesiol. 2011 Feb;60(2):78-82. doi: 10.4097/kjae.2011.60.2.78. Epub 2011 Feb 25. Korean J Anesthesiol. 2011. PMID: 21390161 Free PMC article.
-
Lidocaine for reducing propofol-induced pain on induction of anaesthesia in adults.Cochrane Database Syst Rev. 2016 Feb 18;2(2):CD007874. doi: 10.1002/14651858.CD007874.pub2. Cochrane Database Syst Rev. 2016. PMID: 26888026 Free PMC article.
References
-
- Baker MT, Naguib M. Propofol. The challenges of formulation. Anesthesiology. 2005;103:860–876. - PubMed
-
- Kim KM, Choi BM, Park SW, Lee SH, Christensen LV, Zhou J, et al. Pharmacokinetics and pharmacodynamics of propofol microemulsion and lipid emulsion after an intravenous bolus and variable rate infusion. Anesthesiology. 2007;106:924–934. - PubMed
-
- Fragen RJ, de Grood PM, Robertson EN, Booij LH, Crul JF. Effects of premedication on diprivan induction. Br J Anaesth. 1982;54:913–916. - PubMed
-
- Rolly G, Versichelen L, Huyghe L, Mungroop H. Effect of speed of injection on induction of anaesthesia using propofol. Br J Anaesth. 1985;57:743–746. - PubMed
LinkOut - more resources
Full Text Sources