Injection pain, cardiovascular changes and recovery following induction of anaesthesia with propofol in combination with alfentanil or lignocaine in children

• Published in: Acta anaesthesiologica Scandinavica Vol. 36; no. 6; p. 564
• Main Authors: Hiller, A, Saarnivaara, L
• Format: Journal Article
• Language: English
• Published: England 01.08.1992
• Subjects: Alfentanil - administration & dosage; Alfentanil - therapeutic use; Anesthesia Recovery Period; Anesthesia, Intravenous; Child; Child, Preschool; Double-Blind Method; Female; Hemodynamics - drug effects; Hemodynamics - physiology; Humans; Injections, Intravenous - adverse effects; Lidocaine - administration & dosage; Lidocaine - therapeutic use; Male; Otorhinolaryngologic Diseases - surgery; Pain - etiology; Pain - prevention & control; Propofol
• ISSN: 0001-5172
• DOI: 10.1111/j.1399-6576.1992.tb03519.x

The effect of pretreatment with alfentanil 10 (Alf10), 15 (Alf15) or 20 (Alf20) micrograms.kg-1 on reducing injection pain caused by propofol was compared with lignocaine 10 mg mixed with propofol (Lign). This double-blind, double-dummy and randomized study included 100 children with a mean age of 4.3 +/- 0.6 years, 25 children in each group, undergoing minor otolaryngological surgery. The children were premedicated orally with midazolam 0.5 mg.kg-1 and atropine 0.03 mg.kg-1. Injection pain occurred in 4% in the Lign group. The corresponding figures were 40, 16 and 20% in the Alf10, Alf15 and Alf20 groups, respectively. Both 1% lignocaine 10 mg and alfentanil 15 micrograms.kg-1 reduced injection pain significantly compared with alfentanil 10 micrograms.kg-1. Pretreatment with alfentanil significantly diminished haemodynamic responses to tracheal intubation. Furthermore, the concomitant use of alfentanil and propofol caused transient severe bradycardia and a significant decrease in heart rate after laryngoscopy.