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Low‐dose propofol reduces the incidence of moderate to severe local pain induced by the main dose
Author(s) -
Liljeroth E.,
Karlsson A.,
Lagerkranser M.,
ÅKeson J.
Publication year - 2007
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2006.01255.x
Subject(s) - propofol , medicine , anesthesia , cannula , visual analogue scale , surgery
Background: Local pain on injection of propofol remains a considerable problem in clinical anaesthesiology. As slow infusion of a low dose of propofol induces little or no pain at the site of injection, and as propofol‐induced pain fades during prolonged exposure, this randomized, double‐blind, clinical cross‐over study was designed to test whether pain on injection of propofol is attenuated by initial slow injection of a low dose of propofol by the same intravenous line. Methods: Seventy‐seven adult surgical patients were cannulated in a dorsal vein on each hand. In each cannula, a 0.5‐ml priming dose of either propofol 10 mg/ml dissolved in an emulsion of medium‐ and long‐chain triglycerides or aqueous sodium chloride 9.0 mg/ml was injected over 30 s, and followed 120 s later by a main dose of 2.0 ml of the same propofol formula over 6 s. After each injection, the patients were asked by a blind investigator to score the maximal pain intensity on a visual analogue scale (VAS). Results: Although the decrease in maximal pain intensity did not reach statistical significance ( P = 0.070), significantly fewer patients reported moderate or severe pain intensity (corresponding to 3.0 VAS units or more) after the main dose of propofol was preceded by a priming dose of propofol than by sodium chloride ( P = 0.041). Conclusions: The incidence of moderate to severe local pain induced by intravenous propofol can be decreased by a readily applicable technique in which a low dose of propofol emulsion is slowly administered by the same intravenous route 2 min in advance.