Objective To investigate the effectiveness of pretreatment with mixture of lidocaine and flurbiprofen axetil in reducing injection pain of propofol. Methods One hundred and sixty ASI I–II patients undergoing general anaesthesia were randomly allocated into four groups (40 cases in each group): the control group, the lidocaine (Lc) group, the flurbiprofen axetil (FA) group and the mixture of lidocaine and flurbiprofen axetil (hereafter termed as “mixture”) group. After the occlusion of venous drainage, patients were pretreated with 7 mL of 0.9% saline in the control group, 5 mL (50 mg) of flurbiprofen axetil and 2 mL of 0.9% saline in the FA group, 2 mL (40 mg) of 2% lidocaine and 5 mL of 0.9% saline in the Lc group, and 5 mL (50 mg) of flurbiprofen axetil and 2 mL (40 mg) of 2% lidocaine in the mixture group, respectively. The occlusion was released 2 min later and then 0.5 mg/kg propofol was injected into the vein within 5 s. During injecting propofol, the patients were asked by another anesthetist to assess and record their pain through using VSR. Results No significant differences in the demographic characteristics were found among the four groups. In comparison with the control group, the incidence rates of propofol injection pain were obviously lower in the mixture group, the FA group and the Lc group (Plt;0.05); there was a significant reduction in the incidence rate of pain in the mixture group compared with the other three groups. The median pain score was significantly lower in the mixture group and the Lc group than that in the control group. During the 24 hour follow-up after operation, neither the adverse events such as red-swelling in injection site, phlebitis or drug eruption, nor the gastrointestinal stimulating signs were found. Conclusion The mixture of flurbiprofen axetil and lidocaine is found to be more effective in reducing injection pain of propofol.
ObjectiveTo systematically evaluate the efficacy of different interventions in preventing rocuroniuminduced injection pain or withdrawal movements, so as to provide references for preventing adverse reactions induced by rocuronium injection in clinical practice. MethodsWe electronically searched PubMed, EMbase, The Cochrane Library (Issue 3, 2014), CBM, and CNKI databases to collect randomized controlled trials (RCTs) about the prevention of rocuronium-induced injection pain or withdrawal movements from inception to March 2014. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2.8 software. ResultsA total of 43 RCTs involving 6 034 patients were include. The results of meta-analysis showed that compared with the placebo/blank group, lidocaine pretreatment with venous occlusion (RR=0.37, 95%CI 0.29 to 0.48, P<0.000 01), opioid drug pretreatment with venous occlusion (RR=0.77, 95%CI 0.68 to 0.87, P<0.000 1), lidocaine pretreatment with venous injection (RR=0.51, 95%CI 0.44 to 0.59, P<0.000 01), opioid drug pretreatment with venous injection (OR=0.03, 95%CI 0.02 to 0.05, P<0.000 01), ketamine pretreatment with venous injection (RR=0.36, 95%CI 0.23 to 0.54, P<0.000 01), mixing sodium bicarbonate (NaHCO3) with rocuronium (OR=0.02, 95%CI 0.01 to 0.04, P<0.000 01) and local heating (RR=0.74, 95%CI 0.63 to 0.88, P=0.000 6) were all effective in decreasing the incidence of rocuronium-induced injection pain or withdrawal movements. ConclusionThe intravenous injection of opioid drugs was effective in preventing rocuronium-induced injection pain or withdrawal movements, while local heating needs further research. Due to the limited quantity and quality of the induced studies, the above conclusion still needs to be verified by more high quality studies.
ObjectivesTo systematically review the prophylactic efficacy of lidocaine administrated intravenously in advance on rocuronium associated injection pain/withdrawal movement in patients under general anesthesia.MethodsPubMed, The Cochrane Library, Web of Science, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect relevant randomized controlled trials (RCTs) on pretreatment with lidocaine intravenously to prevent injection pain /withdraw movement from rocuronium from inception to September 30th, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 30 RCTs involving 2 518 patients were included. The results of meta-analysis showed that, compared to the control group, pretreating with intravenous lidocaine could significantly reduced the occurrence of total pain/withdrawal movement associated with rocuronium injection (RR=0.43, 95%CI 0.36 to 0.51, P<0.000 01), and whether with (RR=0.39, 95%CI 0.29 to 0.52, P<0.000 01) or without (RR=0.45, 95%CI 0.36 to 0.57, P<0.000 01) occluding the vein, intravenous lidocaine could prevent pain/withdrawal movement associated with rocuronium injection. In addition, the incidence of lidocaine group igniting moderate (RR=0.38, 95%CI 0.31 to 0.46, P<0.000 01) or severe (RR=0.23, 95%CI 0.18 to 0.30, P<0.000 01) pain/ withdrawal movement were less likely to occur. However, there was no difference between the lidocaine and control group in the incidence of mild injection pain/withdrawal movement induced by rocuronium (RR=0.89, 95%CI 0.75 to 1.06, P=0.19).ConclusionsCurrent evidence shows that pre-intravenous lidocaine can reduce the occurrence of injection pain/withdrawal movement associated with rocuronium injection patients, especially in the prevention of moderate and severe injection pain/withdrawal movement.