| The pain caused by a 2% propofol target-controlled infusion during anesthesia induction in adults. |
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Chul Woo Jung, Jeong Rim Lee, Seung Yeon Yoo, Jung Man Lee, Kook Hyun Lee |
1Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
2Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. manya1@nate.com |
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| Abstract |
BACKGROUND
An increasing number of cases of target-controlled infusion (TCI) of propofol have substituted 2% propofol for 1% due to the concerns about lipid deposition and the practical convenience. However, 2% propofol may possess a higher proportion of free aqueous propofol because of the relatively decreased lipid-solvent ratio as compared to that for 1% propofol. We performed a prospective, randomized, double-blind trial to evaluate the pain of 1% and 2% propofol TCI. The efficacy of lidocaine pretreatment to abolish the pain was also tested for each concentration of propofol.
METHODS
Two hundred adult patients were randomly allocated to 4 groups according to the pretreatment drugs and propofol concentrations; placebo (normal saline) and 1% propofol group (group 1), placebo and 2% propofol group (group 2), lidocaine and 1% propofol group (group 1L), and lidocaine and 2% propofol group (group 2L). Administration of pretreatment drug was followed by TCI with using each concentration of propofol. Pain was assessed using a four-point scale during propofol infusion.
RESULTS
Propofol pain was more frequent (82% vs. 63%, respectively, P = 0.026), and severe (P = 0.002) for the group 2 than for group 1. Pain was significantly reduced by lidocaine pretreatment in the group 2L (48%) and group 1L (19%), as compared with group 2 (82%) and group 1 (63%), respectively (P < 0.001, both). However, group 2L still showed considerable pain that was similar to the pain of group 1.
CONCLUSIONS
TCI of 2% propofol caused more frequent and severe pain despite of lidocaine pretreatment. |
| Key Words:
concentration; lidocaine; pain; propofol |
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