Preventing pain of propofol-induced injection pain : Comparison of lidocaine and remifentanil

Propofol is an intravenously administered, hypnotic and short- acting pharmaceutical. One common sideeffect (>1:10) and therefore a disadvantage with propofol is the local pain that arise when the initial injection is given. Why the pain arise is not clearly understood. A majority of different pharmacological treatments, different doses and combinations, alternative administrations methods and physical interventions have been tried to reduce the pain when injection of propofol is given. One important task for the nurse is to relieve pain for patients. It is important for all patients to be painless and not experience discomfort caused by procedure in health care. The purpose of this study was to examine if administration of lidocaine and/ or remifentanil could in connection with injection of propofol reduce pain incidence and intensity at the injection. A literature study based on twenty-eight scientific articles was conducted. The result shows that a combination of lidocaine andremifentanil give the best pain relief. Howewer there is no difference in propofolinduced injection pain when lidocaine or remifentanil alone is compared. Other factors that could affect injection pain are use of a tourniquet which enhances the pain reduction, but the time that the tourniquet is applied is not decisive. The placement of the iv-catheter should be in the largest vein possible. By using this knowledge the incidence and intensity of pain could be reduced with drugs commonly used in Swedish aneasthetic care. Thereby patients' suffering could also be reduced