Pain on injection from propofol may be avoided by changing its formulation.

BACKGROUND: After using propofol for a decade, pain on injection had been considered routine by patients and medical personnel. When given propofol from a different manufacturer, patients did not complain. Two preparations of propofol were compared. METHODS: A comparative, double-blind, randomized study was conducted in 22 adult patients undergoing pain relief procedures; they received sedation by an intravenous injection of 1.7 mg/kg of propofol and then were treated with paravertebral injections. Pain on injection was assessed by verbal complaint, movement of the extremity, of the whole body and recollection of pain at induction, when discharged. Propofol from Baxter Laboratories, mixed with either 5 ml of 2% lidocaine or 5 ml of NaCl 0.9%, was compared with propofol Laboratorios Gray, which was similarly mixed. Injections were randomly administered four times, blindly, to each of 22 patients. Statistical analysis was conducted using the analysis of variance method. RESULTS: A total of 352 propofol injections were given. Each of the four propofol solutions was administered 88 times; of patients receiving Baxter propofol+saline, 74 (84%) had pain; when mixed with 2% lidocaine 45 (50.2%) complained. After propofol Gray with NaCl 0.9% was given, two patients (2.2%) experienced pain. Propofol Gray with 2% lidocaine produced no pain. None of the latter group remembered having pain, whereas, those given propofol Baxter 54 (61.3%) and 26 (29.5%) remembered experiencing pain at injection. Pain on injection was prevented and statistically reduced (<0.01) with the propofol from Laboratorios Gray. CONCLUSIONS: By changing the formulation (size of molecules and their dispersion) of propofol, pain on injection was avoided.

Risco profissional do anestesiologista de Buenos Aires: investigacion e estudo comparativo com um grupo-controle / Professional risk of the anesthesiologist of Buenos Aires. Research and comparative study with a control-group

Na ultima decada, cientistas de reconhecida hierarquia internacional publicaram importantes investigacoes sobre a contaminacao ambiental nos centros cirurgicos e o risco profissional do anestesiologista decorrente ao trabalho desenvolvido nesse meio. Membros da diretoria da Associacao Argentina de Anestesiologia - Departamento de Buenos Aires decidiram pesquisar seu associados, com a finalidade de verificar condicoes socio-economicas, ambiente de trabalho e se determinadas patologias teriam relacao com a interacao desses fatores. Os autores analisaram 401 pesquisas, representando estas 69,13% dos anestesiologistas de Buenos Aires. Como grupo-controle comparativo foram investigados 65 medicos da Sociedade Argentina de Enfermidades Transmissiveis (83,33% ), que habitualmente nao frequentam centros cirurgicos. Os resultados permitem afirmar que os anestesiologistas, comparados com os colegas do grupo "nao exposto", sofrem das seguintes patologias, resultados estatisticamente significativos: infeccoes cutaneas e oftalmicas, sintomas relacionados com a contaminacao ambiental (cefaleia, nauseas, sonolencia, anorexia, enjoos) e situacoes de estresse pelo trabalho diario (ulcera gastroduodenal, precordialgia, taquicardia Outras patologias, como a hepatite, o infarto do miocardio e anormalidades congenitas em filhos de mulheres anestesiologistas, embora nao tenham sido significativas do ponto de vista estatistico, mostraram uma maior tendencia em relacao ao grupo-controle

Bloqueo peridural con corticoides de deposito en algias neoplasicas y en radiculopatias. / Peridural blocking with depo corticoids in neoplastics pain and in radiculopathies

Se presentaron 19 casos de pacientes tratados con corticoides de deposito por via peridural los que padecian algias neoplasicas y por radiculopatias de otras etiologias. El corticoide utilizado es el Acetato de Metil Prednisolona y el numero de inyecciones vario de acuerdo a la respuesta de cada caso. Se evaluo el resultado de cada tratamiento y se siguio a los pacientes el mayor tiempo posible.(Caso tope 20 meses). De acuerdo a esa evaluacion 12 de los 19 casos estudiados concluyeron con una remision total de la sintomatologia dolorosa, 6 casos resultaron con una remision parcial y 1 ffue un fracaso completo

Bloqueo peridural con corticoides de deposito en algias neoplasicas y en radiculopatias. / Peridural blocking with depo corticoids in neoplastics pain and in radiculopathies

Se presentaron 19 casos de pacientes tratados con corticoides de deposito por via peridural los que padecian algias neoplasicas y por radiculopatias de otras etiologias. El corticoide utilizado es el Acetato de Metil Prednisolona y el numero de inyecciones vario de acuerdo a la respuesta de cada caso. Se evaluo el resultado de cada tratamiento y se siguio a los pacientes el mayor tiempo posible.(Caso tope 20 meses). De acuerdo a esa evaluacion 12 de los 19 casos estudiados concluyeron con una remision total de la sintomatologia dolorosa, 6 casos resultaron con una remision parcial y 1 ffue un fracaso completo