Yoshitaka Fujii1, Yuka Shiga. 1. Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine, Tsukuba City, Ibaraki 305-8525, Japan. yfujii@med.toho-u.ac.jp
Abstract
STUDY OBJECTIVE: To evaluate the influence of aging on lidocaine requirements for propofol-induced pain on injection. DESIGN: Prospective, randomized, double-blind, placebo-controlled study. SETTING: The study was undertaken at a University hospital. PATIENTS: 160 ASA physical status I and II adult patients scheduled for elective surgery with general anesthesia. INTERVENTIONS: Patients received placebo (saline) or lidocaine intravenously at three different doses (10, 20, or 40 mg), with venous occlusion for two minutes, followed by injection of propofol 0.5 mg/kg into a dorsal hand vein. MEASUREMENT AND MAIN RESULTS:Pain during injection of propofol was evaluated. For young patients, the frequency of propofol-induced pain was 70% in patients receiving lidocaine 10 mg (P = not significant); 50% in those receiving lidocaine 20 mg (P = not significant); and 30% in those receiving lidocaine 40 mg (P < 0.05), compared with placebo (80%). For elderly patients, 15 patients (75%) complained of pain in the placebo group, compared with 13 (65%) in the lidocaine 10 mg group (P = not significant); 5 (25%) in the lidocaine 20 mg group (P < 0.05); and 4 (20%) in the lidocaine 40 mg group (P < 0.05). CONCLUSIONS: A lidocaine dose of 40 mg for young patients and 20 mg for old patients, with venous occlusion for two minutes, is sufficient to reduce pain on injection of propofol.
RCT Entities:
STUDY OBJECTIVE: To evaluate the influence of aging on lidocaine requirements for propofol-induced pain on injection. DESIGN: Prospective, randomized, double-blind, placebo-controlled study. SETTING: The study was undertaken at a University hospital. PATIENTS: 160 ASA physical status I and II adult patients scheduled for elective surgery with general anesthesia. INTERVENTIONS:Patients received placebo (saline) or lidocaine intravenously at three different doses (10, 20, or 40 mg), with venous occlusion for two minutes, followed by injection of propofol 0.5 mg/kg into a dorsal hand vein. MEASUREMENT AND MAIN RESULTS:Pain during injection of propofol was evaluated. For young patients, the frequency of propofol-induced pain was 70% in patients receiving lidocaine 10 mg (P = not significant); 50% in those receiving lidocaine 20 mg (P = not significant); and 30% in those receiving lidocaine 40 mg (P < 0.05), compared with placebo (80%). For elderly patients, 15 patients (75%) complained of pain in the placebo group, compared with 13 (65%) in the lidocaine 10 mg group (P = not significant); 5 (25%) in the lidocaine 20 mg group (P < 0.05); and 4 (20%) in the lidocaine 40 mg group (P < 0.05). CONCLUSIONS: A lidocaine dose of 40 mg for young patients and 20 mg for old patients, with venous occlusion for two minutes, is sufficient to reduce pain on injection of propofol.