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Excerpt
I read with interest the article by Huang et al. [1] on a means to reduce pain on injection of propofol. They demonstrated that injecting propofol into a vein while stopping completely the carrier intravenous fluid decreased the incidence and severity of pain caused by propofol.
I have been using this method empirically for a long time, but with a small modification. I connect a small extension tube (volume = 1.0 mL) to the cannula inserted into a peripheral vein. I fill this extension tube with 2% lidocaine. Then, the anesthesia is induced by propofol (2 mg/kg) with no other fluid, and at the same time the lidocaine is pushed into the vein. I have noted that the incidence of pain in my patients is very small.
Lidocaine mixed with propofol has been proven to reduce pain intensity [2]. The combination of the two methods, i.e., no carrier fluid and the addition of lidocaine, appears to me to be very efficient in decreasing the incidence of pain experienced by patients with the injection of propofol.
