• Federico Bilotta, Francesca Ferri, Sulpicio G Soriano, Roberto Favaro, Luciana Annino, and Giovanni Rosa.
• Department of Anesthesiology, Intensive Care and Pain Medicine, University of Rome La Sapienza, Rome, Italy. bilotta@tiscali.it
• Paediatr Anaesth. 2006 Dec 1;16(12):1232-7.

BackgroundWe examined the effect of lidocaine pretreatment before propofol administration on the incidence of transient motor disturbances and on propofol requirements for anesthesia induction in infants and children undergoing repeated painful diagnostic and therapeutic hematological procedures.MethodsA series of 358 children subgrouped according to the presence of a peripheral-vein or central venous catheter were randomly assigned to receive an intravenous dose of 2% lidocaine (2.0 mg.kg(-1)) or an equivalent volume of saline, 1 min before propofol (1.5-3.5 mg.kg(-1)) injected for anesthesia induction.ResultsThe incidence of spontaneous movements was significantly lower in patients pretreated with lidocaine than in those receiving placebo (2.5% vs 29%; P < 0.001, by chi-square test), as was the propofol induction dose (1.6 +/- 0.2 mg.kg(-1) vs 2.2 +/- 0.3 mg.kg(-1); P < 0.001) and pain at the injection site in patients peripheral-vein catheter (12% vs. 54%; P < 0.001). Lidocaine administration also improved children's acceptance as reported by parents on the Observational Scale of Behavioral Distress administered 2 h after the procedure (6.5 +/- 2.5 vs. 9.4 +/- 3.3; P < 0.001). Bouts of coughing developed significantly more frequently after lidocaine pretreatment than after placebo (62.5% vs. 17.5%; P < 0.001).ConclusionsBecause lidocaine pretreatment before the induction of propofol-based anesthesia decreases propofol-induced motor disturbances, lowers hypnotic requirements and reduces pain at the injection site, without inducing untoward events, thus improving children's and parental acceptance, it should become standard practice in infants and children undergoing repeated painful diagnostic and therapeutic hematological procedures.

30 keywords...

hide…