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Revista Brasileira de Anestesiologia
Print version ISSN 0034-7094
UDELSMANN, Artur; SILVA, Waston V; CONCEICAO, Virgínia Maia da and PEREIRA, Rosa Inês Costa. Pain after propofol intravenous injection in children: effects of combined lidocaine and inhalational nitrous oxide. Rev. Bras. Anestesiol. [online]. 2001, vol.51, n.5, pp. 394-400. ISSN 0034-7094. http://dx.doi.org/10.1590/S0034-70942001000500004.
BACKGROUND AND OBJECTIVES: Hospital settings are stressful and fearful for children. Intravenous injections are mostly feared, especially if painful. Propofol is widely used for anesthesia induction but has the disadvantage of pain. This study aimed to compare two analgesic methods for intravenous propofol injection in children. METHODS: Participated in this study 69 pediatric patients admitted for routine procedures under general anesthesia, with an intravenous line on the back of one hand, who were randomly allocated into four groups. Group 1 received previous inhalational O2 for 2 minutes and anesthesia was induced with propofol only. Group 2 inhaled O2 and to each 90 mg of propofol 10 mg of 1% lidocaine were added. Group 3 inhaled 66% N2O and 33% O2 and anesthesia was induced with propofol alone. Group 4 received a combination of both methods: children inhaled 66% N2O with 33% O2 and anesthesia was induced with propofol combined with lidocaine. Pain on induction and heart rate before and after injection were evaluated. RESULTS: Group 4 was the only one with no changes in heart rate after propofol injection. Group 1 had more pain on induction and group 4 had less. Analgesia was insufficient for group 2, and group 3 has only shown a statistical trend to analgesia. Conclusions: Dilution with lidocaine combined with N2O inhalation before intravenous propofol injection showed to be the most efficient method of analgesia for propofol induction in children.
Keywords : ANESTHETICS, Inhalational [nitrous oxide]; Local [lidocaine]; ANESTHETIC TECHNIQUES, Intravenous [induction]; HYPNOTICS [propofol].