BANISH THE BURN A pre-induction injection of lidocaine can mask the pain of propofol.

EASIER INDUCTION
Pre-Propofol Lidocaine Prevents Injection Pain

It's not uncommon for patients undergoing propofol induction to complain of painful sensations at the injection site. For patients whose histories indicate particularly bad experiences, I perform what I call "mini Bier blocks." First I'll apply a tourniquet or venous stasis with a BP cuff, inject 2 to 3 mL of 1% lidocaine, and wait for 2 minutes. Then I'll remove the tourniquet and administer the propofol. I've found this to be effective even among patients who've reported severe pain from propofol with added lidocaine.

Curtis Alleyne, BSc, MBBS, DM
Queen Elizabeth Hospital
Bridgetown, Barbados
[email protected]