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In children, nitrous oxide decreases pain on injection of propofol mixed with lidocaine

[Le protoxyde d’azote diminue la douleur de l’injection d’un mélange de propofol et de lidocaïne chez des enfants]

Terence Beh, MBBS FANZCA^*, William Splinter, MD FRCPC and Jarmila Kim, MD FRCPC

^* From the Department of Anaesthetics, Monash Medical Centre, Victoria, Australia;
and the Department of Anesthesiology, Childrens’ Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Address correspondence to: Dr. Terence Beh, Department of Anaesthetics, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia. Phone: 613-95943283; Fax: 613-95946290; E-mail: t.beh{at}southernhealth.org.au

Purpose: To investigate if 50% nitrous oxide reduces the pain during injection of propofol mixed with lidocaine in children.

Methods: Healthy children undergoing iv induction of general anesthesia for elective surgery were recruited into this prospective, randomized, double-blind study. None of the patients received any premedication except for eutectic mixture of local anesthetics cream. Before induction of anesthesia with propofol 1% mixed with lidocaine 0.05% (propofol dose 3 mg•kg^-1), the treatment group received 50% N₂O in O₂ and the control group received 100% oxygen. Pain due to propofol administration was rated with a four-point behavioural scale: none, mild, moderate or severe.

Results: There were 28 subjects in the control group and 26 subjects in the treatment group. Demographic data were similar in both groups. The incidence of pain at induction was 4% after N₂O and 36% in the control group, P < 0.01. No patients had severe pain. Most patients had mild pain. Three of the ten patients with pain in the control group had moderate pain. The number needed to treat was 3:1.

Conclusion: Nitrous oxide reduces pain during induction with propofol mixed with lidocaine in healthy children.

This article has been cited by other articles:

				R. G. Cox Are children just little adults when it comes to propofol injection pain?/Les enfants ne sont-ils que de jeunes adultes face a la douleur caus'e par l'injection de propofol ? Can J Anesth, December 1, 2002; 49(10): 1016 - 1020. [Full Text] [PDF]