Nitrous oxide/oxygen mixture and the prevention of pain during injection of propofol
Background and objective: The incidence of pain associated with the injection of propofol still remains a problem. This study sought to examine the analgesic effects of inhaled nitrous oxide in oxygen on the prevention of propofol injection pain.
Methods: Nitrous oxide in oxygen was compared with a lidocaine (20 mg)–propofol mixture and with propofol alone (control) in a prospective, randomized, observer-blinded study. ASA I and II patients (n = 135) scheduled for elective surgical procedures were studied. A standard propofol injection technique and scoring system to measure the pain on injection was used.
Results: Demographic variables were similar between the study groups. Without analgesia (control) 26 of 45 patients (58%) reported pain on injection compared with 11 of 45 patients (24%) in both the nitrous oxide (95% CI: 14–52%, P = 0.001) and lidocaine groups (95% CI: 14–52%, P = 0.001).
Conclusions: The inhalation of a nitrous oxide/oxygen mixture significantly reduces the incidence of pain during propofol injection. This therapeutic stratagem was as effective as a lidocaine–propofol mixture.(Accepted April 2002)
Key Words: ANAESTHETICS, INTRAVENOUS, propofol; ANAESTHETICS, LOCAL, lidocaine; INORGANIC CHEMICALS, nitrous oxide; NERVOUS SYSTEM PHYSIOLOGY, SENSATION, pain; PERIPHERAL NERVOUS SYSTEM AGENTS, SENSORY SYSTEM AGENTS.
c1 Correspondence to: Dominic Harmon, Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, Wilton Road, Cork, Ireland. E-mail: [email protected]; Tel: + 353 21 4546400; Fax: + 353 21 4546434