Effect of Lidocaine and Ketorolac on Propofol Injection Pain

Background: Propofol has a high incidence of pain with intravenous injection, and different methods have been used to minimize the incidence and severity of this pain.In this study, we have compared the effect of lidocaine pretreatment with that of ketorolac pretreatment on propofol injection pain.Methods: Sixty children, aged 7-12 years, scheduled for general anesthesia were randomly divided into three groups; saline group (n = 20), lidocaine group (n = 20), and ketorolac group (n = 20).All patients were inserted with a 20 G or 22 G angiocatheter into the veins on the dorsal hand or antecubital fossa.After applying an arm tourniquet at an inflation pressure of 30-40 mmHg, the saline group received 2 ml of 0.9% saline, the lidocaine group received lidocaine 0.75 mg/kg mixed with 2 ml of 0.9% saline, and the ketorolac group received ketorolac 0.75 mg/kg mixed with 2 ml of 0.9% saline.The tourniquet was released 1 minute later, followed by an intravenous injection of 2.5 mg/kg of propofol.Pain and involuntary movement at propofol injection and changes of blood pressure and heart rate were compared. Results:1.The incidence of pain diminished significantly in the lidocaine group (15%) and the ketorolac group (25%) compared with the saline group (80%) at the time of injection of propofol and there was no significant difference between the lidocaine group and the ketorolac group.2. The incidence of involuntary movement diminished significantly in the lidocaine group (grade 0: 80%, grade 1: 20%, grade 2: 0%) and the ketorolac group (grade 0: 65%, grade 1: 30%, grade 2: 5%) compared with the saline group (grade 0: 10%, grade 1: 25%, grade 2: 65%) at the injection of propofol and there was no significant difference between the lidocaine group and the ketorolac group.3. Blood pressure and heart rate significantly increased after intubation in all groups.Conclusions: From the above results, both intravenous lidocaine and ketorolac pretreatment are effective in alleviating propofol injection pain and involuntary movement, but there is no significant difference between the lidocaine group and the ketorolac group.(Korean J Anesthesiol 2002; 43: 325∼331)