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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
Summary
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.
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