A prospective observational study of injection pain in children with medium plus long chain triglyceride and long chain triglyceride propofol premixed with lignocaine.

BACKGROUND AND AIMS

Propofol injection pain is an unresolved problem in children. Although medium and long chain triglyceride (MCT-LCT) propofol has shown promising results in adults, its efficacy in children is not proven. In a prospective observational study the incidence and severity of pain with MCT-LCT and LCT propofol in children was compared.

METHODS

After obtaining approval from the Institutional Ethics Committee, 170 children (age group 6 months to 8 years) scheduled for various surgeries were included in this study. Following standard pre-medication, propofol 1% either LCT or MCT-LCT in a dose of 2-4 mg/kg along with preservative-free lignocaine (2% lignocaine 1 mg in propofol 10 mg) was administered. The primary objective was to study injection pain on scale of 0-6. For children ≤2 years doubling of motor event score (0-3) and for children >2 years, addition of motor (0-3) and verbalisation scores (0-3) were considered. Mann-Whitney U test was used for statistical analysis.

RESULTS

MCT-LCT group had lower incidence of pain (17 patients (20%) versus 35 patients (35.3%), = 0.026) and severe pain (zero patients (0%) versus six patients (7.1%), = 0.029) as compared to LCT group. MCT-LCT group had significantly lower mean rank of motor (79.65 versus 91.35), verbal (77.29 versus 90.79) and total score (77.76 versus 93.24) as compared to LCT group ( = 0.037, 0.002, and 0.009, respectively).

CONCLUSION

MCT-LCT propofol is associated with significantly lower injection pain as compared to LCT propofol in children, when both are combined with lignocaine.