Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T14:17:43.353Z Has data issue: false hasContentIssue false
  • English
  • Français

Discomfort on injection: a comparison between two formulations of propofol

Published online by Cambridge University Press:  07 July 2006

M. A. Allford  and
J. A. Mensah
M. A. Allford
Affiliation:
York District Hospital, Department of Anaesthesia, York, UK
J. A. Mensah
Affiliation:
Scarborough General Hospital, Department of Anaesthesia, Scarborough, N. Yorks, UK
Get access

Abstract

Summary

Background and objective: A randomized double-blind controlled trial was performed to determine if there was a difference in discomfort on injection between two preparations of propofol. A long-chain triglyceride preparation (LCT-propofol (Fresenius)) was compared against a medium- and long-chain triglyceride preparation (MCT/LCT-propofol (BBraun)). Methods: One hundred and twenty ASA I–II patients listed for elective procedures were consented and randomized to receive either induction agent. A standard rate of infusion was used for induction of anaesthesia and subjects were questioned about discomfort until contact was lost. Discomfort was recorded as none, mild, moderate or severe. Incidence of postoperative nausea and vomiting and anti-emetic requirements were recorded in the postanaesthetic care unit. Results: There was seen to be a 54% reduction in moderate/severe discomfort with MCT/LCT-propofol compared with LCT-propofol (P < 0.006). There was a 70% reduction in severe discomfort with MCT/LCT-propofol compared with LCT-propofol (P < 0.04). The term discomfort was used during the study because there is a wide array of unpleasant sensations felt by patients during propofol induction which are not always reported as pain. There was no significant difference in the incidence of postoperative nausea and vomiting or anti-emetic use between the two groups. Conclusions: There is a significant decrease in the incidence of discomfort with MCT/LCT-propofol compared with LCT-propofol. This difference is more marked in subjects reporting severe discomfort.

Keywords

ANAESTHESIA INTRAVENOUSPROPOFOLINTRAOPERATIVE COMPLICATIONSPOSTOPERATIVE NAUSEA AND VOMITING
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 11 , November 2006 , pp. 971 - 974
Copyright
2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Scott RP, Saunders DA, Norman J. Propofol: clinical strategies for preventing the pain of injection. Anaesthesia 1988; 43 (6): 492–494.Google Scholar
Lyons B, Lohan D, Flynn C, McCarroll M. Modification of pain on injection of Propofol. A comparison of pethidine and lignocaine. Anaesthesia 1996; 51 (4): 394–395.Google Scholar
Picard P, Tramer M. Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg 2000; 90: 963–969.Google Scholar
Sun NC, Wong AY, Irwin MG. A comparison of pain on injection between two preparations of propofol. Anesth Analg 2005; 101: 675–678.Google Scholar
Kam E, Abdul-Latif MS, McCluskey A. Comparison of Propofol-Lipuro with propofol mixed with lidocaine 10 mg on propofol injection pain. Anaesthesia 2004; 59: 1167–1169.Google Scholar
Shaub E, Kern C, Landau R. Pain on injection: a double-blind comparison of propofol with lidocaine pre-treatment versus propofol formulated with long- and medium-chain triglycerides. Anesth Analg 2004; 99: 1699–1702.Google Scholar
Rau R, Roizen M, Doenicke A, O'Connor M, Strohschneider U. Propofol in an emulsion of long- and medium-chain triglycerides: the effect on pain. Anesth Analg 2001; 93: 382–384.Google Scholar
Larsen B, Beerhalter U, Bielder Aet al. Less pain on injection by a new formulation of propofol? A comparison with Propofol-LCT. Anästhesist 2001; 50: 842–845.Google Scholar
Klement W, Arndt JO. Pain on injection of propofol: effects of concentration and diluent. Br J Anaesth 1991; 67: 281–284.Google Scholar
Babl J, Doenicke AW, Mönch V. New formulation of propofol in an LCT/MCT emulsion. Approach to reduce pain on injection. Eur Hosp Pharm 1995; 1: 15–21.Google Scholar
Müller RH, Harnisch S. Physicochemical characterization of propofol-loaded emulsions and interaction with plasma proteins. Eur Hosp Pharm 2000; 6: 24–31.Google Scholar
Morishima T, Sobue K, Arima Het al. Profound pain due to propofol injection triggered myocardial ischemia in a patient with a suspected phaeochromocytoma. Anesth Analg 2003; 96: 631.Google Scholar