TYK92

Which of the following decreases the pain of injection of IV propofol?

A. Slowing the speed of injection

B. Warming the injectate

C. Preinjection of IV of lidocaine/analgesics

D. Lidocaine-tourniquet technique (Bier block)

E. Increasing the size of vein selected for injection

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Answer

The answer is D.

A systematic review in A&A reviewed the various "cures" for pain on injection of propofol. The only one that seemed to be effective was the Bier block like technique. IV lidocaine (0.5 mg/kg) should be given with a [rubber] tourniquet on the forearm, 30 to 120 s before the injection of propofol; lidocaine will prevent pain in approximately 60% of the patients treated in this manner.^[1]

Notes

↑ Pascale, and Martin R. Tramer. "Prevention of pain on injection with propofol: a quantitative systematic review." Anesthesia & Analgesia 90.4 (2000): 963-969.

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[1] Pascale, and Martin R. Tramer. "Prevention of pain on injection with propofol: a quantitative systematic review." Anesthesia & Analgesia 90.4 (2000): 963-969.

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