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Propofol and pain on induction: the effect of injectate temperature in children
A Pickford1, J Burden, I Lewis
1Shackleton Department of Anaesthetics, Level E, Centre Block, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
Insights
Cooled intravenous propofol did not significantly reduce pain during anesthesia induction in children. While the cooled group showed a lower incidence of pain, the difference was not statistically significant.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
Background:
- Pain on induction of anesthesia is a common issue in pediatric patients.
- Propofol is frequently used for anesthesia induction.
- Lidocaine is often co-administered to mitigate propofol injection pain.
Purpose of the Study:
- To investigate if cooling intravenous propofol reduces pain during anesthesia induction in children.
- To compare the incidence and severity of pain between room temperature and cooled propofol injections.
Main Methods:
- Prospective, randomized, double-blind study design.
- Seventy pediatric patients (3-10 years, ASA I/II) received either room temperature (20-23°C) or cooled (4°C) 1% propofol with 0.05% lidocaine.
- Pain assessed by a blinded observer using a behavioral scale.
Main Results:
- Data analyzed from 69 patients.
- Incidence of pain: 26% (room temperature group) vs. 14% (cooled group).
- The difference in pain incidence was not statistically significant (P=0.21). Pain scores were similar between groups.
Conclusions:
- Cooling intravenous propofol to 4°C did not significantly decrease the incidence or severity of pain during anesthesia induction in children.
- Further research may be needed to explore alternative methods for reducing injection pain in pediatric anesthesia.
Abstract:
A prospective, randomized, double-blind study was conducted to determine whether cooled intravenous propofol reduces the incidence of pain on induction of anaesthesia in children. Seventy patients aged 3-10 years, ASA I or II, were randomized to receive 1% propofol plus 0.05% lidocaine either at room temperature (20-23 degrees C) or cooled to 4C. Pain was assessed by a blinded observer using a behavioural scale. Data from 69 patients were analysed. The incidence of pain was 9/34 (26%, 95% confidence intervals 11-41%) in the room temperature injectate group and 5/35 (14%, 95% confidence intervals 3-26%) in the cold injectate group. These differences were not statistically significant (P=0.21, chi-squared test). Pain scores were similar in both groups.