Induction pain perception after premedication with propofol vs lidocaine: a pilot study

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Propofol is a common intravenous sedative-hypnotic for general anesthesia induction.
• Propofol administration can cause significant burning pain at the intravenous site.
• Preinduction pharmacologic agents are often used to mitigate this discomfort.

Purpose of the Study:

• To compare the effectiveness of preinduction lidocaine versus propofol in reducing pain during propofol-induced anesthesia.
• To explore potential cost and time savings by eliminating lidocaine use.

Main Methods:

• Thirty patients (ASA physical status I or II) were randomly assigned to receive either 20 mg propofol or 40 mg lidocaine intravenously before anesthesia induction.
• The induction dose of propofol (2.5 mg/kg) was administered through the same IV site after the preinduction agent.
• Patients reported pain severity (mild, moderate, severe) if discomfort was experienced.

Main Results:

• No statistically significant difference was found in the overall incidence of pain prevention between the lidocaine and propofol groups.
• 53% of patients in the lidocaine group and 47% in the propofol group were pain-free.
• When pain occurred, it was more likely to be classified as severe in the propofol group (50%) compared to the lidocaine group (14%).

Conclusions:

• Neither preinduction lidocaine nor propofol demonstrated a significant difference in reducing the overall incidence of pain during propofol induction.
• Preinduction propofol may be associated with a higher likelihood of severe pain, though this requires further study due to small sample size.
• Further research is warranted to explore effective strategies for blunting pain associated with propofol administration.