Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942007000100004
Brazilian Journal of Anesthesiology
Scientific Article

Efeitos do tratamento prévio com lidocaína, paracetamol e lidocaína-fentanil por via venosa na dor causada pela injeção de propofol: estudo comparativo

Effect of pretreatment with lidocaine, intravenous paracetamol and lidocaine-fentanyl on propofol injection pain: comparative study

Khaled M. El-Radaideh

http://dx.doi.org/10.1590/S0034-70942007000100004 Braz J Anesthesiol, vol.57, n1, p.32-38, 2007
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Resumo

JUSTIFICATIVA E OBJETIVOS: Foi realizado estudo duplamente encoberto, aleatório, para avaliar a eficácia do tratamento prévio, por via venosa, com lidocaína, paracetamol (Perfalgan®) ou lidocaína associada ao fentanil na redução da dor causada pela injeção de propofol. MÉTODOS: Imediatamente após a oclusão venosa com torniquete de borracha foi feita a administração venosa de 4 mL de lidocaína a 1% (Grupo L, n = 50), 4 mL de paracetamol (Perfalgan®) (40 mg) (Grupo R, n = 50), lidocaína a 2% associada a 100 µg de fentanil (Grupo LF, n = 50) ou 4 mL de solução fisiológica a 0,9% (Grupo P, n = 50; grupo-controle com placebo) a 200 adultos. A liberação da obstrução venosa foi feita após 60 segundos, sendo seguida da administração venosa de propofol, 2,5 mg.kg-1 a uma velocidade de 0,5 mg.s-1 através de cateter 20G inserido na veia do dorso da mão. A avaliação da dor foi feita durante a injeção de propofol. Ela incluiu movimentos da mão, expressão verbal espontânea de dor, caretas e gemidos durante a injeção de propofol. RESULTADOS: Lidocaína-fentanil (70% sem dor) e lidocaína (68% sem dor) foram mais eficazes na redução da dor causada pela injeção de propofol do que o paracetamol (54% sem dor) e o placebo (36% sem dor) (p < 0,05). A diferença na redução da incidência de dor causada pela injeção de propofol entre a lidocaína e lidocaína-fentanil não foi significativa. O paracetamol foi muito superior ao placebo (p < 0,05). CONCLUSÕES: O propofol é um anestésico amplamente utilizado. Lidocaína e lidocaína-fentanil administrados como tratamento prévio, na forma de retenção venosa durante 60 segundos, antes da administração do propofol reduziram de forma acentuada a dor causada pela injeção de propofol, enquanto o paracetamol (Perfalgan®) reduziu discretamente essa mesma dor.

Palavras-chave

ANESTÉSICOS, Venoso, COMPLICAÇÕES, dor à injeção

Abstract

BACKGROUND AND OBJECTIVES: Performed a randomized, double blind study to assess the efficacy of intravenous (IV) pretreatment with lidocaine, IV paracetamol (Perfalgan®) or lidocaine mixed with fentanyl in reducing propofol injection pain. METHODS: Immediately after venous occlusion with a rubber tourniquet on the patient's arm IV lidocaine 1% 4 mL (Group L, n = 50), IV paracetamol (Perfalgan®) 4 mL (40 mg) (Group R, n = 50), lidocaine 2% mixed with 100 µg fentanyl (Group LF, n = 50) or normal saline 4 mL (Group P, n = 50; as placebo control) was given to 200 adult patients. The release of the venous occlusion was done after 60s and followed by intravenous administration of propofol 2.5 mg.kg-1 at rate of 0.5 mg.s-1 through a 20G catheter inserted in hand dorsum vein. Pain assessment was made during the propofol injection. This included movement of hand, spontaneous verbal expressions of pain, frowning, and moaning during the injection of propofol. RESULTS: Lidocaine-fentanyl (70% pain free), and lidocaine (68% pain free) significantly reduced propofol injection pain more than paracetamol (54% pain free) and more than placebo (36% pain free) (p < 0.05). The difference in reducing the incidence of propofol injection pain between lidocaine and lidocaine-fentanyl did not reach statistical significance. There was a significant superiority of paracetamol compared to placebo (p < 0.05). CONCLUSIONS: Propofol, a commonly used anesthetic. Given as a venous retention pretreatment 60 seconds before propofol, lidocaine and lidocaine-fentanyl were found to significantly reduce the propofol injection pain, whereas IV paracetamol (Perfalgan®) slightly reduced the propofol injection pain.

Keywords

ANESTHETICS, Intravenous, COMPLICATIONS: pain on injection

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