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. 2010 May;58(5):435-9.
doi: 10.4097/kjae.2010.58.5.435. Epub 2010 May 29.

Pain reduction on injection of microemulsion propofol via combination of remifentanil and lidocaine

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Pain reduction on injection of microemulsion propofol via combination of remifentanil and lidocaine

Yong Ku Han et al. Korean J Anesthesiol. 2010 May.

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.

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Figures

Fig. 1
Fig. 1
Hemodynamic changes after the propofol and remifentanil injection. The blood pressure and heart rate are the mean values that were maintained within the normal limits in all three groups and there was no hypotension or bradycardia during the study period. MBP baseline: MBP before injecting the study drug, MBP remifentanil: MBP after the remifentanil injection, MBP Aquafol: MBP after the Aquafol injection, MBP intubation: MBP 1 min after intubation. HR baseline: baseline HR, HR remifentanil: HR after the remifentanil injection, HR Aquafol: HR after the Aquafol injection, HR intubation: HR 1 min after intubation. MBP: mean blood pressure, HR: heart rate.

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