Avoiding pain during propofol injection in pediatric anesthesia: Hypnoanalgesia of the hand versus intravenous lidocaine.

Autor: Polomeni MM; Department of Anesthesia and Intensive Care, University Hospital of Toulouse, Toulouse, France.; Department of Anesthesia and Intensive Care, Children Hospital, University Hospital of Toulouse, Toulouse, France., Huguet T; Department of Anesthesia and Intensive Care, University Hospital of Toulouse, Toulouse, France., Mariotti M; Department of Pediatric Analgesia and Palliative Care, Children Hospital of Toulouse, Toulouse, France., Larcher C; Department of Anesthesia and Intensive Care, University Hospital of Toulouse, Toulouse, France.; Department of Anesthesia and Intensive Care, Children Hospital, University Hospital of Toulouse, Toulouse, France., Delort F; Department of Anesthesia and Intensive Care, University Hospital of Toulouse, Toulouse, France.; Department of Anesthesia and Intensive Care, Children Hospital, University Hospital of Toulouse, Toulouse, France., Minville V; Department of Anesthesia and Intensive Care, University Hospital of Toulouse, Toulouse, France., Kern D; Department of Anesthesia and Intensive Care, University Hospital of Toulouse, Toulouse, France.; Department of Anesthesia and Intensive Care, Children Hospital, University Hospital of Toulouse, Toulouse, France.
Jazyk: angličtina
Zdroj: Paediatric anaesthesia [Paediatr Anaesth] 2024 Aug; Vol. 34 (8), pp. 742-749. Date of Electronic Publication: 2024 May 02.
DOI: 10.1111/pan.14909
Abstrakt: Introduction: Pain related to injection of propofol during induction of anesthesia decreases from 66.8% without prevention, to 22-31% of cases when lidocaine is associated. Hypnoanalgesia of the hand is currently used for painful procedures in children but has never been evaluated in this indication. The primary aim of this prospective randomized single-blind study was to evaluate the efficacy of hypnoanalgesia of the hand for the prevention of moderate to severe pain during intravenous injection of propofol alone in comparison to lidocaine admixture. The secondary aim was to compare the global satisfaction of children in both methods.
Patients and Methods: One hundred patients aged 7-14 years, ASA 1-2, admitted for scheduled surgery under general anesthesia were randomized into two groups. Group L received a mixture of 1% propofol (3 mg/kg) and 1% Lidocaine (0.3 mg/kg). Group H received 1% propofol (3 mg/kg) after hypnoanalgesia of the hand realized by a single experimented operator. A video was made in order to evaluate the pain related to propofol injection by a blinded observer using the 4-point score of Cameron (painful ≥ 2). The global satisfaction of children was evaluated in postanesthesia care unit and documented if visual analog score was <7/10.
Results: Ninety-six patients were analyzed. The rate of painful patients did not differ significantly between groups (8.5% in group H [n = 47] vs 6.1% in group L [n = 49], OR= 0.70; 95% CI [0.13-3.35], p = 0.65), nor did the rate of nonsatisfied patients (10.6 in group H vs. 12.2% in group L, OR = 0.85; 95% CI [0.19-3.65], p = 1).
Conclusions: Our results suggest that hypnoanalgesia of the hand alone is effective to prevent the pain related to propofol injection in children. No significant difference was found in comparison with lidocaine admixture nor for pain or satisfaction.
(© 2024 The Authors. Pediatric Anesthesia published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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