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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We evaluated the efficacy of the 60% lidocaine tape in alleviating pain associated with intravenous propofol administration in 71 gynecological patients. Thirty-eight women had the tape applied for 2.5 h before venipuncture, with the remaining patients acting as the control. A 20 gauge cannula was inserted into the cephalic vein. Propofol at room temperature was injected at a rate of 1200 ml.hr-1. The statistical significance of differences was established with the Mann-Whitney's U test and the chi 2 test. The median level of pain intensity resulting from venipuncture among the patients treated with the tape was smaller than that in the control group (16.5, vs 34, P = 0.006). Thereafter, cannulation was successfully achieved with reduced or no pain (VAS at cannulation < or = 25, n = 39), and only 16% of the treatment group complained of pain on injection as compared with 53.8% of the control group (P = 0.02). Moreover, the pain intensity was decreased with lidocaine tape (P = 0.006). The cost of the lidocaine tape is covered by medical insurance for reducing pain on venipuncture. Thus, as the tape also alleviates the pain on injection of propofol through its anesthetic action, it can be a safe, easy and cost-effective method as "it kills two pains with one tape".
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PMID:[Sixty percent lidocaine tape alleviates pain on injection of propofol after diminishing venipuncture pain]. 972 Mar 32

Total intravenous anesthesia has recently become available for ambulatory surgery. It has the advantages of decreased air contamination from volatile anesthetics and decreased exposure of operating room personnel to volatile anesthetics. The purpose of this study was to compare the anesthetic properties of propofol/ketamine (total intravenous) anesthesia and thiopentone/halothane (intravenous and gaseous) anesthesia for herniorrhaphy or hydrocelectomy in children. Sixty children aged 2 to 7 years scheduled for herniorrhaphy or hydrocelectomy were allocated to two groups. The propofol/ketamine group (group 1) received a loading dose of intravenous propofol 3 mg/kg followed by propofol infusion 200 micrograms/kg/minute; additional bolus doses of propofol 1 mg/kg were given as needed or the infusion dose was increased or decreased by 33 micrograms/kg/minute as needed. Ketamine 1 mg/kg was administered intravenously 2 to 3 minutes before herniorrhaphy or hydrocelectomy to reinforce the analgesic and anesthetic effects of propofol. The thiopentone/halothane group (group 2) received intravenous thiopentone 6 mg/kg followed by halothane with 40% oxygen using a mask. Group 2 patients maintained spontaneous breathing with intermittent assistance and group 1 patients maintained spontaneous natural airway breathing during anesthesia. The scores on the postoperative assessment scale were higher in group 2 patients, indicating poorer anesthesia recovery characteristics, but the differences were not significant. Pain on injection was more frequent in group 1 (12/32) than in group 2 (2/28). The incidence of vomiting in group 2 (6/28) was significantly higher than in group 1 (0/32). We conclude that propofol/ketamine allows patients to maintain spontaneous natural airway breathing during anesthesia, and its analgesic and anesthetic effects are comparable to those of thiopentone/halothane. Propofol/ketamine is appropriate for pediatric herniorrhaphy and hydrocelectomy. It can be recommended for pediatric ambulatory surgery.
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PMID:Anesthesia for pediatric herniorrhaphy or hydrocelectomy: comparison of propofol/ketamine and thiopentone/halothane. 974 67

We compared the effect of fentanyl and lidocaine on pain during injection of propofol. One hundred and sixty patients premedicated with midazolam were randomly allocated to one of four groups (n = 40, respectively); Group C, propofol 2 mg.kg-1; Group F, fentanyl 0.1 mg 3 min prior to propofol; Group L, lidocaine 40 mg added to 200 mg propofol; Group FL, fentanyl 0.1 mg 3 min prior to propofol mixed with lidocaine 40 mg. Propofol was injected via a vein on the dorsum of the hand in a half of the patients in each Group or the forearm vain in the other half. The incidence of pain was significantly less in both Group F (40%) and Group L (35%) compared with Group C (80%, P < 0.01). There was no significant difference in the incidence of pain between Group F and Group L. Group FL had the least incidence of pain (5%) of all Groups. Injection via the forearm vain tended to reduce the severity of pain compared with the vain on the dorsum of the hand. The time until loss of consciousness was significantly less in the groups receiving fentanyl than the groups without fentanyl (P < 0.01). In conclusion, prior administration of fentanyl is as effective as premixing of lidocaine in preventing the pain on injection of propofol, and the simultaneous application of them may abolish the pain.
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PMID:[Reduction of pain on injection of propofol: a comparison of fentanyl with lidocaine]. 975 61

The latencies of pain threshold to different subhypnotic doses (12.5, 25 and 50 mg kg-1) of propofol, an anaesthetic, administered intraperitoneally (i.p.) into male mice were measured using a hot plate method. The possible mechanism of pain control by propofol was also investigated through blocking beta-endorphin receptors and measuring serum level of beta-endorphin. Morphine (1.5 mg kg-1; i.p.) was used as a reference of reduction of pain sensation. The results showed that propofol in doses of 25 and 50 mg kg-1 significantly (P < 0.01) increased the latency of pain threshold but a lower dose (12.5 mg kg-1) failed to produce any significant change. This indicates that propofol reduced pain and this effect is dose-dependent. Propofol prevents hyperalgesia produced by prostaglandin PGE2, (0.5 mg kg-1, i.p.; P < 0.01). Pretreatment with naloxone (1.0 mg kg-1, i.p.) abolished significantly (P < 0.01) the antinociceptive action of propofol. Furthermore, serum level of beta-endorphin was increased (P < 0.01) after propofol injection particularly at the peak time of propofol action. The serum level of corticosterone was also increased (P < 0.01) at the time of beta-endorphin release. It was concluded that propofol can control pain and this action may be centrally modulated through the opioid system rather than at the level of the spinal cord.
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PMID:Effect of propofol on perception of pain in mice: mechanisms of action. 977 4

We have studied the antibacterial activity of different concentrations of 0.005-2% lidocaine (lignocaine) in mixtures with Diprivan (propofol), against micro-organisms commonly implicated in sepsis as a result of extrinsically contaminated Diprivan. Bacterial colony counts were reduced progressively with increasing concentrations of lidocaine. Bacteriostatic and bactericidal concentrations of lidocaine were 0.2-2%. Lidocaine 2% was not bactericidal for one of the seven organisms tested. By inhibiting bacterial replication, lidocaine, when added to Diprivan to reduce pain on injection, may possibly reduce the harmful consequences if extrinsic contamination occurs.
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PMID:Antibacterial activity of lidocaine in mixtures with Diprivan. 1061 45

Propofol-ketamine technique is a room air, spontaneous ventilation (RASV), intravenous dissociative anesthetic technique which simulates the operating conditions of general anesthesia without the increased equipment requirements or costs. A total of 2059 procedures were performed on 1264 patients by 38 different surgeons. There were no hospital admissions for postoperative nausea and vomiting (PONV) or uncontrolled pain. All patients were pleased with their anesthetic and no hallucinations were reported. Cost:benefit analysis is presented as well as discussion of dissociative anesthesia being exempt from current California law (AB595).
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PMID:Propofol-ketamine technique: dissociative anesthesia for office surgery (a 5-year review of 1264 cases). 1002 41

We compared propofol injected through a central venous catheter with that through a peripheral cannula from the standpoint of injection pain, induction time and hemodynamic changes. Thirty-nine patients about to receive abdominal surgery, who had central venous catheters inserted via the subclavian vein, were included in this study. General anesthesia was induced with a loading dose of propofol 1 mg.kg-1 followed by an infusion of 10 mg.kg-1.hr-1 into the central vein without carrier intravenous fluid (group A, n = 13), the peripheral vein without carrier intravenous fluid (group B, n = 13) or the peripheral vein with rapid infusion of acetated Ringer's solution (group C, n = 13). After endotracheal intubation, anesthesia was maintained with propofol 4 mg.kg-1.hr-1. The incidence of injection pain was 53% in group B and 76% in group C, whereas none of the patients in group A felt discomfort or pain during propofol injection. The mean induction time was significantly shorter in group A (43 +/- 12 sec) than group B (66 +/- 16 sec) or group C (57 +/- 11 sec). There were no differences between each group in hemodynamic changes during induction of anesthesia. Propofol injection via central venous catheter can avoid the injection pain and shorten the induction time.
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PMID:[Induction of anesthesia with propofol injected through a central venous catheter]. 1003 92

The reduction in propofol-induced pain on injection caused by the addition of lignocaine results mainly from a drop in pH, which reduces the concentration of propofol in the aqueous phase of the emulsion. It is not an effect of the local anaesthetic per se. Propofol emulsion mixed with lignocaine destabilizes within hours. We mixed 10 parts of propofol 1% emulsion with one part of 0.0064 M HCl or 0.013 M HCl, respectively. These mixtures were stored for 3 months and compared with a freshly prepared solution of propofol 1% emulsion and saline, in the same proportion, regarding their ability to induce anaesthesia in the rat. There was no significant difference in the amount of propofol required to induce anaesthesia, nor was there any difference in recovery time between the three groups.
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PMID:Acidified propofol retains its anaesthetic potency after storage. 1022 65

Lignocaine added to the anaesthetic preparation Diprivan reduces propofol induced pain on injection. This effect is due to a drop in pH which decreases the content of propofol in the aqueous phase of the soya bean emulsion. This in turn changes the electrostatic forces in the emulsion and destabilization occurs. The effect of lignocaine on the anaesthetic potency of propofol was validated in a randomized blind study in the rat. The induction dose of 1% propofol mixed with 1% lignocaine (10 + 1) was significantly higher when compared with the induction dose of propofol 1% given after a separate injection of 1% lignocaine (9.4 +/- 5.5 vs. 5.6 +/- 5.2 mg; P < 0.05). The duration of sleep was shorter in rats injected with propofol 1% mixed with lignocaine 1% (10 + 1) compared with those given 1% lignocaine and 1% propofol in separate injections (160 +/- 181 vs. 375 +/- 202 s; P < 0.05). The anaesthetic potency of propofol was not significantly changed by the addition of either saline or hydrochloric acid. The anaesthesia inducing effect was not time-dependent. A similar lower potency was observed for a solution stored for 4 h compared with one freshly prepared, although sleeping time was longer (9.2 +/- 6.8 mg; 428 +/- 110 s) as compared with the 4 h mixture. The results indicate that lignocaine altered the propofol preparation. The reduced anaesthetic potency of propofol after addition of lignocaine is not due to the resultant drop in pH, which is known to occur.
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PMID:The anaesthetic potency of propofol in the rat is reduced by simultaneous intravenous administration of lignocaine. 1086 14

Assisted reproduction may be associated with repeated occasions of surgical intervention. Propofol, which is frequently used for induction of anaesthesia in such procedures, has been suspected of damaging oocytes. We compared in a randomized prospective design the use of general anaesthesia with fentanyl 0.017 mg/kg, propofol 2.5 mg/kg and isoflurane to that of sedation with midazolam 0.06 mg/kg and ketamine 0.75 mg/kg for transvaginal oocyte retrieval in 50 patients with no premedication. Overall, patient satisfaction was not different between the groups. Sedated patients were more arousable than anaesthetized patients during the procedure and experienced less postoperative abdominal pain at 30 min. Despite some movement in response to pain, oocyte retrieval was conveniently feasible in all sedated patients, of which none required a switch to general anaesthesia. A comparable number of oocytes was retrieved per cycle, 10.8 (+/-7.8) versus 9.6 (+/-10.9) with sedation and anaesthesia respectively. No patient recalled any pain sensation during the procedure. The rate of embryo transfers and pregnancies were not different between the two groups. We conclude that the sedative combination of midazolam and ketamine for oocyte retrieval may serve as an alternative for general anaesthesia.
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PMID:Midazolam/ketamine sedative combination compared with fentanyl/propofol/isoflurane anaesthesia for oocyte retrieval. 1040 83


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