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Comparison of lidocaine versus dexmedetomidine in preventing propofol induced injection pain during induction of general anaesthesia in Chinese patient undergoing gynaecologic surgery: real world evidence

Objective: To compare the efficacy and safety of lidocaine and dexmedetomidine in preventing propofolinduced pain in routine clinical practice.

Materials and Methods: In this single center, prospective, non-interventional observational study, the women of ASA grade I or II with age between 18 to 65 years who were scheduled to undergo elective gynaecologic surgery under general anaesthesia with the use of propofol during 2010-2015 were enrolled. Patients received dexmedetomidine (0.2 mcg/kg, intravenously) and lidocaine (0.2 mg/kg, intravenously) at least 30 minutes prior to propofol injection (2 mg/kg) for induction during general anaesthesia. Pain after propofol injection was assessed from each patient after pre-treatment of lidocaine and dexmedetomidine using McCrirrick and Hunter scale for pain evaluation.

Results: A total of 1560 patients (778 patients in lidocaine groups and 782 patients in dexmedetomidine groups) were analysed. Both dexmedetomidine and lidocaine significantly decreased pain after administration of propofol in Chinese patents undergoing elective surgery. Significant reduction in pain score was found higher among patients who received lidocaine as compared to dexmedetomidine (p<0.05). Moreover, onset of analgesia after lidocaine injection was significantly shorter when compared dexmedetomidine among patients who received propofol (p=0.04). Approximately 65% of patients treated with lidocaine had no pain after propofol injection; this was significantly higher when compared with dexmedetomidine (p<0.05).

Conclusion: We suggest lidocaine is superior to dexmedetomidine in reducing propofol induced pain. Pre-treatment with intravenous injection of lidocaine was found better alternative to dexmedetomidine injection in management of propofol induced pain. Both the treatment is having acceptable safety profile.

Author(s): Yan-bin He, Du-yu Li, Zhong Tan