Reduction of Propofol-Induced Pain through Pretreatment with Lidocaine and/or Flurbiprofen.

OBJECTIVE

Pain is a well recognised complication of propofol injection. The purpose of this study was to compare the efficacy of flurbiprofen, lidocaine and a combination of the two in reducing pain on injection of propofol.

DESIGN

Prospective, randomised, double-blind, placebo-controlled study.

SETTING

University hospital in Tsukuba City, Japan.

PATIENTS AND INTERVENTIONS

120 patients, 56 males and 64 females, aged 20-66 years, scheduled for elective plastic surgery were included. Patients received intravenously either lidocaine 20mg, flurbiprofen 50mg, both, or placebo (saline) accompanied by manual venous occlusion for 2 minutes, followed by administration of propofol 2 mg/kg into a dorsal hand vein (n = 30 in each group). A blinded researcher asked each patient to evaluate the pain score (0 = none, 1 = mild, 2 = moderate, 3 = severe) during propofol injection.

MAIN OUTCOME MEASURES AND RESULTS

The incidence and intensity of pain was less in patients receiving lidocaine (27%, pain score 0 [median]), flurbiprofen (43%, 0), or both (3%, 0) along with venous occlusion than in those receiving placebo (90%, 2) along with venous occlusion (p < 0.01). Combined lidocaine and flurbiprofen with venous occlusion was the most effective treatment (p < 0.05). No complications such as pain, oedema, wheal or flare response were observed at the injection sites within the first 24 hours after surgery.

CONCLUSION

Combined lidocaine 20mg and flurbiprofen 50mg along with venous occlusion for 2 minutes was very effective for reducing pain on injection of propofol in patients scheduled for elective plastic surgery.