Reduction of propofol pain--fentanyl vs lidocaine

To compare the local efficacy of lidocaine and fentanyl in reducing propofol injection pain (PIP), we conducted a prospective randomized double-blind study in 75 ASA I and II adult patients. When administered 20 seconds before propofol with a venous tourniquet, lidocaine but not fentanyl or placebo, reduced the incidence of moderate to severe pain on subsequent injection of propofol (P < 0.001). Two patients (8%) in the lidocaine group (n = 25) experienced a moderate degree of pain and none experienced severe pain. Fifteen (60%) in the fentanyl group (n = 25) experienced moderate or severe degrees of pain, compared with 15 (60%) in the saline group (n = 25). We conclude that lidocaine, acting locally, reduce propofol injection pain while fentanyl does not.