A Randomized Comparison of the Buzzy® Personal Pain Relief Device to Intravenous Lidocaine for Controlling Injection Pain During Intravenous Propofol Induction of Anesthesia in Children
A Randomized Comparison of the Buzzy® Personal Pain Relief Device to Intravenous Lidocaine for Controlling Injection Pain During Intravenous Propofol Induction of Anesthesia in Children
Propofol is a drug commonly used for induction of general anesthesia in children as well as adults; however, propofol can cause pain on injection, possibly more frequently in children. One common method of preventing propofol injection pain is the injection of lidocaine just prior to the injection of propofol through an intravenous catheter. This practice is sometimes, but not universally, effective, and involves exposure of patients to an additional drug. Our proposal is to use a non-pharmacologic adjunct in an attempt to attenuate the pain of propofol injection. The Buzzy® personal pain relief device is an FDA-approved product that provides non-pharmacologic relief of pain from minor painful procedures in children. The investigators propose the non-invasive Buzzy® personal pain relief device might prove just as effective at relieving the pain of propofol injection as the injection of intravenous lidocaine just prior to propofol injection. Randomized groups and a blinded observer will be used in this study of 106 children, with one group of patients receiving a current standard of care for reduction of the pain of propofol injection, that is, lidocaine prior to propofol, and one group receiving the placement of the Buzzy® device above the injection site prior to injection of propofol to reduce the pain of propofol injection.
Inclusion Criteria:
Patients who are in the American Society of Anesthesiologists physical status classification I to III (meaning healthy patients, patients with mild systemic disease, and patients with serious controlled systemic disease) between the ages of 12 and 17 presenting from home for procedures including, but not limited to, upper and lower endoscopy, orthopedic surgery, and medical imaging will be enrolled.
Exclusion Criteria:
Based on history and physical examination, patients requiring a rapid sequence induction of anesthesia and patients requiring an emergency procedure will be excluded. Standard institutional practice is to place IVs in children over 12 before surgery. There are some patients who, due to needle phobia, may prefer a mask induction of anesthesia, but at this age, but this is the exception rather than the rule. If a child was determined to require a mask induction, they would be excluded from the study.