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Propofol as an induction agent in children: pain on injection and pharmacokinetics
M Valtonen1, E Iisalo, J Kanto
1Department of Anaesthesiology, University of Turku, Finland.
Insights
Adding lignocaine (1 mg) to propofol significantly reduces injection pain in children undergoing surgery. This combination did not affect propofol
Area of Science:
- Anesthesiology
- Pediatric Pharmacology
- Pain Management
Background:
- Propofol injection pain is a common issue in pediatric anesthesia.
- Lignocaine is often used to mitigate injection pain.
- Understanding propofol pharmacokinetics in children is crucial for safe administration.
Purpose of the Study:
- To evaluate the efficacy of lignocaine in reducing propofol injection pain in children.
- To assess the impact of lignocaine on propofol's induction characteristics.
- To investigate the pharmacokinetics of propofol in pediatric patients.
Main Methods:
- A double-blind, randomized controlled trial comparing lignocaine (1%) with glucose (5%) mixed with propofol in 40 children.
- Pharmacokinetic analysis of propofol (2.5 mg/kg) in 8 children.
- Pain on injection was assessed using a standardized scale.
Main Results:
- Lignocaine significantly reduced pain on injection compared to glucose (P < 0.001).
- Propofol induction characteristics and drug interactions were unaffected by lignocaine.
- The first-stage elimination half-life of propofol in children was shorter than in adults (mean 9.3 ± 3.8 min).
Conclusions:
- Lignocaine is effective in reducing propofol injection pain in pediatric patients.
- Lignocaine does not adversely affect propofol's anesthetic properties or safety profile.
- Shorter propofol elimination half-life in children may necessitate dose adjustments for continuous infusions or repeated administrations.
Abstract:
The efficacy of lignocaine (1%) mixed with propofol in reducing pain on injection with propofol was studied in 40 children undergoing elective surgery in a double-blind, randomized comparison with glucose (5%). The pharmacokinetics of propofol in a single dose of 2.5 mg/kg was also studied in eight children participating in the same study. Lignocaine (1 mg) significantly reduced pain on injection compared to the control group (P less than 0.001). The induction characteristics of propofol were not affected by the lignocaine, and no undesirable interaction was found between the two drugs. The first-stage elimination half-life (t1/2 beta) of propofol in children was shorter (mean 9.3 +/- 3.8 (s.d.) min) than the values found in adults. This pharmacokinetic alteration may have clinical significance following repeated administration or continuous infusion of propofol.