Preventive methods for reducing propofol-induced pain by intravenous administration

master's thesis

• Title (croatian): Preventivne metode za smanjivanje boli izazvane intravenskom primjenom propofola
• Author: Thomas Volpe
• Mentor: DINKO TONKOVIĆ (mentor)
• Committee member: DINKO TONKOVIĆ (predsjednik povjerenstva)
• Committee member: Mladen Perić (član povjerenstva)
• Committee member: Slobodan Mihaljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2018-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Propofol is the most widely used intra-venous (IV) anesthetic for induction and maintenance of anesthesia. Its pharmacokinetics and pharmacodynamics properties make it an almost ideal anesthetic agent, but paradoxically it is painful on injection. Pain on propofol injection (POPI) is mostly a minor problem but its high incidence and its potentially high intensity of pain makes it important to solve in order to improve the practice of anesthesiology. This review article highlights the causes and solutions to POPI with a chronological approach, from the discovery of propofol to the latest remedies of the current practice. The mechanism of pain is still under investigation even though recent researches have achieved a huge step toward its understanding. It is probable that its comprehension will result in better preventive methods. As for now, IV lidocaine seems to be the best pharmacological option in the prevention of POPI considering its availability, price and rare adverse effects. On the other hand, recommended non-pharmacological measure to prevent POPI is rapid injection of propofol into a large vein. Latest recommendation on the subject promote usage of a combination of local anesthetic with a central sedative and rapid injection into large vein.

Abstract (croatian)

Propofol je najčešće korišten intra-venski (IV) anestetik za indukciju i održavanje anestezije. Njegova farmakokinetička i farmakodinamična svojstva čine ga gotovo idealnim sredstvom za anesteziju, ali paradoksalno, bolno je kod injekcije. Bol na injekciji propofola (POPI) je uglavnom manji problem, ali njegova visoka učestalost i njezin potencijalno visok intenzitet boli čine važnim pronaći rješenje kako bismo poboljšali praksu anesteziologije. Ovaj pregledni članak ističe uzroke i rješenja POPI-a kronološkim pristupom, od otkrića propofola do najnovijih lijekova u praksi. Mehanizam boli još je pod istragom, iako su nedavna istraživanja postigla veliki korak prema njenom razumijevanju. Vjerojatno će njegovo razumijevanje rezultirati boljim preventivnim metodama. Kao i za sada, lidokain IV čini se najboljom farmakološkom opcijom u sprječavanju POPI-a s obzirom na njegovu dostupnost, cijenu i rijetke nuspojave. S druge strane, preporučena nefarmakološka mjera za sprječavanje POPI je brzo injektiranje propofola u veliku venu. Najnovija preporuka na temu promovira korištenje kombinacije lokalnog anestetika sa središnjim sedativom i brzo ubrizgavanje u veliku venu.

• Keywords: propofol; pain; prevention
• Keywords (croatian): propofol; bol; prevencija
• Language: english
• URN:NBN: urn:nbn:hr:105:973400
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-03-28 10:41:28