Intravenous lidocaine pretreatment with venous occlusion for reducing microemulsion propofol induced pain: comparison of three doses of lidocaine.

Abstract

OBJECTIVE: Pretreatment with intravenous 40 mg or 0.5 mg/kg lidocaine with venous

occlusion is recommended to prevent pain following injection of lipid emulsion

propofol. This approach is not sufficient to prevent pain from the injection of

microemulsion propofol. The present study investigated whether a higher dose of

lidocaine pretreatment with venous occlusion would be more effective for reducing

pain following injection of microemulsion propofol compared with 40 mg lidocaine.

METHODS: Patients undergoing elective surgery were randomly assigned to one of

three groups: pretreatment with 40 mg (group L40), 60 mg (group L60) or 80 mg

(group L80) lidocaine intravenously with venous occlusion, followed by injection

with microemulsion propofol 1 min later. Pain was assessed on a four-point scale

(severe, moderate, mild, none) based on physical responses to the injection.

RESULTS: A total of 68 patients were included in the final analysis. Pain

severity and incidence were significantly lower in patients in group L60 and L80

compared with patients in group L40. There were no statistically significant

differences in pain incidence or severity between group L60 and group L80.

CONCLUSIONS: Pretreatment with 60 mg lidocaine intravenously with venous

occlusion may be the most effective minimum dose for reducing injection pain

following microemulsion propofol administration for induction of anaesthesia.