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Tourniquet at 50 mm Hg followed by intravenous lidocaine diminishes hand pain associated with propofol injection.
Anesthesia and Analgesia 1992 Februrary
We evaluated the efficacy of intravenous lidocaine, with and without a tourniquet, to decrease the intensity of pain during intravenous propofol injection in 82 patients undergoing general anesthesia. Patients in group A (n = 20) received propofol (2 mg/kg IV); patients in group B (n = 22) received 2% lidocaine (100 mg IV) followed 1 min later by propofol (2 mg/kg). Patients in group C (n = 21, saline placebo) and D (n = 19, 2% lidocaine) had an arm tourniquet inflated to 50 mm Hg applied for 1 min after gravity drainage of venous blood. The intensity of pain along the forearm was marked on a 0-100-mm visual analogue scale. Pain intensity was less in group B (21 +/- 19 mm) than in group A (75 +/- 28 mm; P less than 0.05). Pain intensity was significantly less in group D (1 +/- 2 mm) compared with group B (21 +/- 19 mm; P less than 0.001). We conclude that intravenous lidocaine before propofol injection attenuates the painful response; whereas, lidocaine administered after a tourniquet inflated to 50 mm Hg for 1 min virtually abolishes the pain associated with intravenous propofol.
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