Lidocaine in prevention of pain on propofol anesthetic induction: A randomized double-blinded clinical trial to estimate the magnitude of the effect

Luíza Buffon, Alexandre C Buffon*, Paulo Freitas, Nazaré O Nazário, Jefferson Traebert and Anna Paula Piovezan

Background and objectives: Sedation with propofol is a part of the anesthetic induction procedure because it provides anxiolysis, amnesia and hypnosis; however, up to 5% of patients have pain at propofol injection and of these, 1% of them have severe or excruciating pain. There are several techniques that are used to avoid it, including previous venous administration of lidocaine, a local anesthetic. Although it is widely used, this procedure is not absent of risks, since many adverse reactions are reported when using lidocaine, such as blurred vision, nausea, headache and many others Central Nervous System symptoms. The current randomized controlled study evaluated the Number Needed to Treat (NNT) of patients that receives lidocaine to reduce pain associated to propofol administration during anesthesia induction.

Methods: This is a prospective, double-blinded, randomized trial with 970 adult subjects who were submitted to propofol administration in the induction of anesthesia. Investigated groups were previously treated randomly, either with lidocaine or saline and then they were interrogated about pain during propofol injection. 

Results: There were no differences in demographics between the study groups. Pain outcome was reduced in patients who received lidocaine (5%; 95% CI, 3.63–6.37) in relation to saline (14.2%; 95% CI, 12.0-16.4). However, the number needed to treat (NNT= 10.9) for prevention of this effect was considerably high. 

Conclusion: This study suggests that the use of lidocaine prior to propofol application is not justified, if considered the risk factors for the patient and the savings related with the procedure.

Clinical trial registration: UTN 1111-1215-1557.

Keywords:

Published on: Nov 27, 2020 Pages: 34-37

Full Text PDF Full Text HTML DOI: 10.17352/ojpm.000021
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