• Yoshitaka Fujii and Yuka Shiga.
• Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine, Tsukuba City, Ibaraki 305-8525, Japan. yfujii@med.toho-u.ac.jp
• J Clin Anesth. 2006 Nov 1;18(7):526-9.

Study ObjectiveTo evaluate the influence of aging on lidocaine requirements for propofol-induced pain on injection.DesignProspective, randomized, double-blind, placebo-controlled study.SettingThe study was undertaken at a University hospital.Patients160 ASA physical status I and II adult patients scheduled for elective surgery with general anesthesia.InterventionsPatients received placebo (saline) or lidocaine intravenously at three different doses (10, 20, or 40 mg), with venous occlusion for two minutes, followed by injection of propofol 0.5 mg/kg into a dorsal hand vein.Measurement And Main ResultsPain during injection of propofol was evaluated. For young patients, the frequency of propofol-induced pain was 70% in patients receiving lidocaine 10 mg (P = not significant); 50% in those receiving lidocaine 20 mg (P = not significant); and 30% in those receiving lidocaine 40 mg (P < 0.05), compared with placebo (80%). For elderly patients, 15 patients (75%) complained of pain in the placebo group, compared with 13 (65%) in the lidocaine 10 mg group (P = not significant); 5 (25%) in the lidocaine 20 mg group (P < 0.05); and 4 (20%) in the lidocaine 40 mg group (P < 0.05).ConclusionsA lidocaine dose of 40 mg for young patients and 20 mg for old patients, with venous occlusion for two minutes, is sufficient to reduce pain on injection of propofol.

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