Related Experiment Video

Updated: Jul 4, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Avoiding propofol injection pain in children: a prospective, randomized, double-blinded, placebo-controlled study

A Rochette1, A F Hocquet, C Dadure

  • 1Department of Anaesthesia and Intensive Care A, Hôpital Lapeyronie, Montpellier, France. a-rochette@chu-montpellier.fr

British Journal of Anaesthesia
|June 24, 2008
PubMed

Insights

A new propofol emulsion using medium-chain/long-chain triglycerides (MCT/LCT) significantly reduced injection pain in preschool children. Combining this new emulsion with lidocaine virtually eliminated pain, improving pediatric anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Pharmacology
  • Pain Management

Background:

  • Pain on injection is a significant limitation for propofol use in pediatric patients.
  • Lidocaine is commonly combined with propofol to mitigate injection pain.
  • A novel medium-chain/long-chain triglyceride (MCT/LCT) propofol emulsion has shown reduced pain in adults, but its efficacy in preschool children is unknown.

Purpose of the Study:

  • To evaluate the injection pain associated with a new MCT/LCT propofol emulsion compared to standard LCT propofol in preschool children.
  • To assess the effect of lidocaine when combined with either propofol emulsion on injection pain.

Main Methods:

  • A prospective, randomized, double-blinded, placebo-controlled study involving 160 children under 7 years old.
  • Participants received either LCT-propofol or MCT/LCT-propofol with either lidocaine or saline.
  • Pain was assessed using a 0-6 scale based on verbal and motor reactions during injection.

Main Results:

  • Both propofol emulsions showed reduced pain scores compared to LCT-propofol with saline (P<0.001).
  • The MCT/LCT-propofol combined with lidocaine group exhibited the least pain (P<0.001).
  • Painless injections (score 0-2) occurred in 92.5% of patients receiving MCT/LCT-propofol with lidocaine, versus 41-77% in other groups (P<0.001).

Conclusions:

  • The MCT/LCT propofol emulsion significantly reduces injection pain in preschool children compared to standard LCT propofol.
  • The addition of lidocaine to the MCT/LCT propofol emulsion further decreases pain, effectively eliminating it during injection.
Abstract

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...