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[Injection pain from propofol-MCT-LCT in children. A comparison with propofol-LCT]
R Larsen1, U Beerhalter, R Erdkönig
1Klinik für Anästhesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, Kirrbergerstrasse, 66421 Homburg/Saar. airlar@med-rz.uni-sb.de
Insights
Propofol-MCT/LCT 1% caused less injection pain and arm withdrawal in children compared to Propofol-LCT. This new formulation, Propofol-Lipuro, is superior for pediatric anesthesia induction.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacology
Background:
- Propofol is a widely used anesthetic agent.
- Pain on injection is a common side effect of propofol.
- Different propofol formulations exist, varying in their lipid emulsion composition.
Purpose of the Study:
- To compare the incidence and intensity of injection pain between two propofol formulations in children.
- To evaluate Propofol-MCT/LCT (Propofol-Lipuro) against Propofol-LCT (Disoprivan) for pediatric anesthesia induction.
Main Methods:
- Prospective, randomised, double-blind study involving 40 children (aged 7-14 years).
- Premedication with oral diazepam.
- Induction of anesthesia involved injecting 20% of the calculated propofol dose into a dorsal hand vein.
- Pain, spontaneous pain expression, and arm withdrawal were assessed.
Main Results:
- Significantly fewer children reported pain with Propofol-MCT/LCT (10%) compared to Propofol-LCT (25%).
- Significantly less arm withdrawal was observed with Propofol-MCT/LCT (10%) versus Propofol-LCT (40%).
Conclusions:
- Propofol-MCT/LCT 1% (Propofol-Lipuro) significantly reduces injection pain and arm withdrawal in children aged 7-14 years.
- Propofol-MCT/LCT demonstrates superior tolerability compared to Propofol-LCT for anesthesia induction in this pediatric population.
Objectives:
This prospective, randomised, double-blind study was designed to compare the incidence and intensity of pain on injection of propofol formulated in a mixture of medium- and long-chain triglycerides, Propofol-MCT/LCT 1% (Propofol-Lipuro, B. Braun, Germany) with propofol in a commonly used emulsion of long-chain triglycerides, Propofol-LCT 1% (Disoprivan, Zeneca) in children undergoing elective surgical procedures.
Methods:
After approval of the local ethics committee 40 children, aged 7-14 years, were enrolled in the study. Premedication was with 5-10 mg diazepam orally one hour before induction of anesthesia. In the beginning 20% of the calculated dose of Propofol for induction was injected into a separate venous cannula in a dorsal vein of the hand; patients were observed for expressing pain spontaneously during injection patients or were asked to describe the sensations after 10 s. Withdrawal of the arm during injection was also noted.
Results:
Significantly more children reported pain on injection of propofol-LCT compared to Propofol-MCT/LCT (25% vs, 10%) and significantly more children retracted their arm during injection of propofol-LCT (40% vs. 10%).
Implications:
Propofol-MCT/LCT 1% (Propofol-Lipuro) for induction of anesthesia produced significantly less pain on injection and significantly less drawing back of the arm when compared to Propofol-LCT (Disoprivan). Thus, with respect to pain on injection Propofol-MCT/LCT appears to be superior to Propofol-LCT in children aged 7-14 years.