Use of Lidocaine to Reduce the Propofol Induced Pain during Induction of General Anesthesia in Adult

Servan Kumar; Kelash Kumar; Pardeep Kumar; Pardeep Mankani

doi:10.70749/ijbr.v3i5.1134

Authors

Servan Kumar Department of Anaesthesiology and Intensive Care Unit, Liaquat University of Medical and Health Science Jamshoro and Liaquat University Hospital Hyderabad, Pakistan
Kelash Kumar Department of Anaesthesiology and Intensive Care Unit, Liaquat University of Medical and Health Science Jamshoro and Liaquat University Hospital Hyderabad, Pakistan
Pardeep Kumar Department of Anaesthesiology and Intensive Care Unit, Liaquat University of Medical and Health Science Jamshoro and Liaquat University Hospital Hyderabad, Pakistan.
Pardeep Mankani Department of Anaesthesiology and Intensive Care Unit, Liaquat University of Medical and Health Science Jamshoro and Liaquat University Hospital Hyderabad, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i5.1134

Keywords:

Randomized Controlled Trial, Lidocaine, Propofol, Injection Pain, and General Anesthesia

Abstract

Introduction: Propofol is a commonly used intravenous anesthetic agent characterized by a short induction and recovery time. However, its injection is often characterized by moderate to severe pain, thus making it uncomfortable for patients. Lidocaine has been investigated as one of the agents that can be useful in the reduction of this pain. Objective: To evaluate the efficacy of intravenous lidocaine in reducing propofol-induced pain during induction of general anesthesia in adult patients. Materials and Method: This comparative study was conducted on 110 adult patients selected from elective lower limb surgeries at Liaquat University of Medical & Health Sciences, Hyderabad, Pakistan from January 2024, to June 2024. There were two groups the first group was given 40 mg lidocaine and the second group was given saline. Pain was calculated with the help of a tool known as the Verbal Numerical Rating Score (VNRS). Results: Lidocaine significantly decreased the prevalence and intensity of propofol injection pain, 89.1% of patients in Group L reported mild pain compared to 49.1 % of patients in Group C (p < 0.001). Conclusion: The use of lidocaine can minimize propofol injection pain, and it should be used routinely during induction.

Downloads

Download data is not yet available.

References

Jinat, S., 2023. Comparison Between Propofol Vs Lidocaine Pretreatment For Propofol Injection Pain Among Patients Undergoing General Anesthesia (Doctoral dissertation, Faculty of Graduate Studies Comparison Between Propofol Vs Lidocaine Pretreatment For Propofol Injection Pain Among Patients Undergoing General Anesthesia By Sahar Jinat Supervisor Dr. Jamal Qaddumi This Thesis is Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Nursing Anesthesia, Faculty of Graduate Studies, An-Najah National University).

Hu, S., Wang, M., Li, S., Zhou, W., Zhang, Y., Shi, H., Ye, P., Sun, J., Liu, F., Zhang, W. and Zheng, L., 2022. Intravenous lidocaine significantly reduces the propofol dose in elderly patients undergoing gastroscopy: a randomized controlled trial. Drug Design, Development and Therapy, pp.2695-2705.

https://doi.org/10.2147/dddt.s377237

Qi, X.R., Sun, J.Y., An, L.X. and Zhang, K., 2022. Effect of intravenous lidocaine on the ED50 of propofol for inserting gastroscope without body movement in adult patients: a randomized, controlled study. BMC anesthesiology, 22(1), p.319.

https://doi.org/10.1186/s12871-022-01861-9

Wu, C.M., Zhang, W.S., Liu, J., Zhang, W.Y. and Ke, B.W., 2021. Efficacy and safety of fospropofol disodium for injection in general anesthesia induction for adult patients: a phase 3 trial. Frontiers in Pharmacology, 12, p.687894.

https://doi.org/10.3389/fphar.2021.687894

Tang, L., Lv, W., Sun, J. and Chen, L., 2024. Effect of intravenous lidocaine on the ED50 of propofol induction dose in elderly patients undergoing painless gastroscopy: a prospective, randomized, double-blinded, controlled study. Perioperative Medicine, 13(1), p.15.

https://doi.org/10.1186/s13741-024-00370-2

Tian, S., Zhang, D., Zhou, W., Tan, C., Shan, Q., Ma, R., Xing, Z., Sui, W. and Zhang, Z., 2021. Median effective dose of lidocaine for the prevention of pain caused by the injection of propofol formulated with medium-and long-chain triglycerides based on lean body weight. Pain Medicine, 22(6), pp.1246-1252.

https://doi.org/10.1093/pm/pnaa316

Ratanshi, N.A. and Mandour, Y., 2021. Should lidocaine routinely be used to prevent pain on propofol injection during induction of general anaesthesia or sedation?. British Journal of Hospital Medicine, 82(1), pp.1-3.

https://doi.org/10.12968/hmed.2020.0473

Chachart, V., 2025. Evaluation of the Effectiveness of Lidocaine and Ketamine Injections in Reducing Pain from Propofol Injection in General Anesthesia. Anesthesia and Pain of Society Journal, 1(1), pp.26-31.

Khadka, B. and Sharma, N.R., 2021. A Comparative Study between Ketamine and Lidocaine or Decrease Propofol Injection Pain During Induction of Anesthesia. Birat Journal of Health Sciences, 6(1), pp.1304-1309.

https://doi.org/10.32474/gjapm.2020.03.000165

Ashfaq, S., Malik, M.F., Asghar, F., Sabir, S., Imran, S. and Niazi, R.H.K., 2025. Comparison of Lignocaine with Ondansetron for Attenuation of Propofol-Induced Pain in Adult Patients Undergoing Laparoscopic Cholecystectomy: Lignocaine Versus Ondansetron for Propofol Pain. Pakistan Journal of Health Sciences, pp.02-06.

https://doi.org/10.54393/pjhs.v6i3.2886

Hudaib, M., Malik, H., Zakir, S.J., Rabbani, S., Gnanendran, D., Syed, A.R.S., Suri, N.F., Khan, J., Iqbal, A., Hussain, N. and Abdullah, M., 2024. Efficacy and safety of ciprofol versus propofol for induction and maintenance of general anesthesia: a systematic review and meta-analysis. Journal of Anesthesia, Analgesia and Critical Care, 4(1), p.25.

https://doi.org/10.1186/s44158-024-00160-8

Alipour, M., Shahroudi, A. and Morovatdar, N., 2023. Efficacy of sufentanil and lidocaine on propofol injection pain. International Journal of Anesthesiology and Practice (IJAP), 2(1), pp.2994-2624.

https://doi.org/10.58489/2994-2624/004

Guan, X., Jiao, Z., Gong, X., Cao, H., Liu, S., Lan, H., Huang, X., Tan, Y., Xu, B. and Lin, C., 2021. Efficacy of pre-treatment with remimazolam on prevention of propofol-induced injection pain in patients undergoing abortion or curettage: a prospective, double-blinded, randomized and placebo-controlled clinical trial. Drug design, development and therapy, pp.4551-4558.

https://doi.org/10.2147/dddt.s334100

Nigussie, E., Aregawi, A., Abrar, M., Hika, A., Aberra, B., Tefera, B. and Teshome, D., 2021. Lidocaine versus propofol administration on the attenuation of hemodynamic responses during extubation in the adult elective surgical patient: a prospective cohort. Heliyon, 7(8).

https://doi.org/10.1016/j.heliyon.2021.e07737

Wu, Q., Xu, F., Wang, J. and Jiang, M., 2024. Efficacy and Safety of Ketamine Compared with placebo and other medications for preventing Propofol Injection Pain in adults: a systematic review and Meta-analysis. Journal of Pain Research, pp.459-476.

https://doi.org/10.2147/jpr.s440250