Abstract
This study investigated propofol injection pain in patients undergoing ambulatory anaesthesia. In a randomized, double-blind trial, 90 women were allocated to receive one of three treatments prior to induction of anaesthesia with propofol. Patients in Group C received 2 ml normal saline, Group L, 2 ml, lidocaine 2% (40 mg) and Group T, 2 ml thiopentone 2.5% (50 mg). Venous discomfort was assessed with a visual analogue scale (VAS) 5–15 sec after commencing propofol administration using an infusion pump (rate 1000 μg · kg−1 · min−1). Loss of consciousness occurred in 60–90 sec. Visual analogue scores (mean ± SD) during induction were lower in Groups L (3.3 ± 2.5) and T (4.1 ± 2.7) than in Group C (5.6 ± 2.3); P = 0.0031. The incidence of venous discomfort was lower in Group L (76.6%; P < 0.05) than in Group C (100%) but not different from Group T (90%). The VAS scores for recall of pain in the recovery room were correlated with the VAS scores during induction (r = 0.7045; P < 0.0001). Recovery room discharge times were similar: C (75.9 ± 19.4 min); L 73.6 ± 21.6 min); T (77.1 ± 18.9 min). Assessing their overall satisfaction, 89.7% would choose propofol anaesthesia again. We conclude that lidocaine reduces the incidence and severity of propofol injection pain in ambulatory patients whereas thiopentone only reduces its severity.
Résumé
Cette étude évalue la douleur à l’injection du propofol en anesthésie ambulatoire. Au cours d’une étude randomisée et à double aveugle, 90 sujets du sexe féminin sont répartis en trois groupes. Au moment de l’induction, les patients du groupe C reçoivent 2 ml de soluté physiologique, celles du groupe L, 2 ml de lidocaine (40 mg), et celles du groupe T, 2 ml de thiopentone (50 mg). La douleur à l’injection est évaluée sur une échelle visuelle analogique (EVA), 5–15 sec après le début de l’administration du propofol avec une pompe à perfusion (vitesse 1000 μg · kg−1 · min−1). La perte de conscience survient en 60–90 sec. Les scores sur l’EVA pendant l’induction sont plus bas dans les groupe L (3,3 ± 2,5) et T (4,1 ± 2,7) que dans le groupe C (5,6 ± 2,3); P = 0,0031). L’incidence de la douleur est plus basse dans le groupe L (76,6%; P < 0,05) que dans le groupe C (100%) mais n’est pas différente dans le groupe T (90%). Les scores sur l’EVA pour l’évocation douloureuse sont en corrélation avec les scores enregistrés à l’induction (r = 0,7045; P < 0,0001). La durée du séjour en salle de réveil est la même pour les trois groupes: C (75,9 ± 19,4 min); L (73,6 ± 21,6 min); T (77,1 ± 18,9 min). En ce qui concerne la satisfaction générale, 89,7% des patientes choisiraient de nouveau l’anesthésie au propofol. Les auteurs concluent que la lidocaine diminue l’incidence et l’intensité de la douleur à l’injection du propofol alors que le thiopentone n’en réduit que l’intensité.
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Haugen, R.D., Vaghadia, H., Waters, T. et al. Thiopentone pretreatment for propofol injection pain in ambulatory patients. Can J Anaesth 42, 1108–1112 (1995). https://doi.org/10.1007/BF03015097
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DOI: https://doi.org/10.1007/BF03015097