Effect of low dose ephedrine and lidocaine on pain and hemodynamic changes due to propofol injection

The aim of this study was to compare the intensity of pain and hemodynamic changes during propofol injection when pretreatment is performed with ephedrine and lidocaine. In a randomized double blind clinical trial [IRCT: 2766] in Shahid Rajaee Hospital during the year 2009, 99 patients with ASA physical status I and II, aged 20 to 50 years were recruited. The patients were planned to undergo elective surgeries under general anesthesia and had no history of cardiocascular, neurologic, or allergic diseases. The subjects were randomly assigned into three groups to receive 40mg intravenous lidocaine [group L], 30|jg/kg ephedrine [group E] or 2ml normal saline [group P]. After one minute, 2mg/kg propofol was injected into a dorsal hand vein. Pain was assessed using face pain scale [FPS]. Arterial blood pressure and heart rate were also recorded before induction, just before intubation, and one minute after intubation. Hemodynamic changes and also the incidence and intensity of pain in group L were less than the other groups. The patients in group L had significantly lower FPS compared with group P [P=0.004] and patients in group E had lower FPS compared with group P; however, the difference was not statistically significant [P=0.247]. Pretreatment with a small dose of ephedrine [30 micro g/kg] reduces the incidence and intensity of propofol induced pain. Although lidocaine is more effective, ephedrine results in a more stable hemodynamic status

[Effect of 10% lidocaine spray on postoperative sore throat]

Sore throat is a common complication after surgery. Application of 10% lidocaine spray on cuff of a tracheal tube maybe associated with decreased risk of postoperative sore throat. The purpose of this study was to determine the effect of 10% lidocaine spray on postoperative sore throat. This double-blind study was conducted at Rajaei Hospital in Qazvin during 2008-2009. Two hundred ASA I-III surgical patients [except the neck surgery] aged 9-81 years and without signs of common cold, were randomly divided into two groups. The subject group received aerosolized lidocaine [5 puffs] on cuff of the tracheal tube before tracheal intubation. The patients in control group received normal saline instead. Later, the patients underwent a standardized general anesthesia. These patients were interviewed when leaving the recovery room and re-questioned for the presence of sore throat the following day in the wards. Data were analyzed using the chi-square test and Fisher's exact test. Findings: Sore throat was present in 29% of subject group and 22% of control group while in the recovery room. Sore throat decreased to 16% and 17% on the day after surgery. There was no significant difference in incidence of sore throat between two groups based on duration of surgery and the patient's sex when in the recovery room or wards. It seems that the application of aerosolized lidocaine on cuff of the tracheal tube before tracheal intubation fails to decrease the incidence of postoperative sore throat