logo
episode-header-image
Oct 2020
28m 30s

18: Is mixing in lidocaine effective for...

DAVID HAO, MD
About this episode

In this episode, we discuss the mechanisms of burning with propofol infusion and explore the evidence behind strategies like mixing lidocaine with propofol.

Our guest today is Dr. Stu Forman, Professor of Anesthesiology at Massachusetts General Hospital. He is an investigator on several NIH-sponsored basic research grants and co-director of the Harvard Anesthesia Research Training Fellowship.

Connect with us @DepthAnesthesia on Twitter or email us at depthofanesthesia@gmail.com.

Thanks for listening! Please rate us on iTunes and share with your colleagues. 

Music by Stephen Campbell, MD. 

--

References

Bengalorkar GM, Bhuvana K, Sarala N, Kumar T. Fospropofol: clinical pharmacology. J Anaesthesiol Clin Pharmacol. 2011 Jan;27(1):79-83. PMID: 21804712; PMCID: PMC3146164.

Dajun Song, Mohamed A. Hamza, Paul F. White, Stephanie I. Byerly, Stephanie B. Jones, Amy D. Macaluso; Comparison of a Lower-lipid Propofol Emulsion with the Standard Emulsion for Sedation during Monitored Anesthesia Care. Anesthesiology 2004; 100:1072–1075 doi: https://doi.org/10.1097/00000542-200405000-00007

Euasobhon P, Dej-Arkom S, Siriussawakul A, Muangman S, Sriraj W, Pattanittum P, Lumbiganon P. Lidocaine for reducing propofol-induced pain on induction of anaesthesia in adults. Cochrane Database Syst Rev. 2016 Feb 18;2(2):CD007874. doi: 10.1002/14651858.CD007874.pub2. PMID: 26888026; PMCID: PMC6463799.

Fischer MJ, Leffler A, Niedermirtl F, Kistner K, Eberhardt M, Reeh PW, Nau C. The general anesthetic propofol excites nociceptors by activating TRPV1 and TRPA1 rather than GABAA receptors. J Biol Chem. 2010 Nov 5;285(45):34781-92. doi: 10.1074/jbc.M110.143958. Epub 2010 Sep 7. PMID: 20826794; PMCID: PMC2966094.

Jalota L, Kalira V, George E, Shi YY, Hornuss C, Radke O, Pace NL, Apfel CC; Perioperative Clinical Research Core. Prevention of pain on injection of propofol: systematic review and meta-analysis. BMJ. 2011 Mar 15;342:d1110. doi: 10.1136/bmj.d1110. PMID: 21406529.

Klement W, Arndt JO. Pain on i.v. injection of some anaesthetic agents is evoked by the unphysiological osmolality or pH of their formulations. Br J Anaesth. 1991 Feb;66(2):189-95. doi: 10.1093/bja/66.2.189. PMID: 1817619.

Sahinovic MM, Struys MMRF, Absalom AR. Clinical Pharmacokinetics and Pharmacodynamics of Propofol. Clin Pharmacokinet. 2018;57(12):1539-1558. doi:10.1007/s40262-018-0672-3

Scott RP, Saunders DA, Norman J. Propofol: clinical strategies for preventing the pain of injection. Anaesthesia. 1988 Jun;43(6):492-4. doi: 10.1111/j.1365-2044.1988.tb06641.x. PMID: 3261547.

__

By listening to this podcast, you agree not to use information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Opinions expressed are solely those of the host and guests and do not express the views or opinions of Massachusetts General Hospital.

Up next
Apr 9
40: Are peripartum opioids safe for breastfeeding mothers?
Dr. Gopika Hari and Dr. Lana Joudeh join the podcast to discuss the literature on the safety of peripartum opioid use and its implications for breastfeeding. Dr. Hari is an anesthesia resident in the MGH Anesthesia Residency Program and a graduate of Washington University School ... Show More
41m 29s
Jan 2025
39: Should opioid-free anesthesia be implemented? A Pro-Con Debate.
Dr. Mary Daniels and Dr. Scott Cao join the show to discuss the literature surrounding opioid-free versus opioid-based anesthesia and analgesia techniques. Dr. Scott Cao is currently serving as a chief resident of the MGH anesthesia residency program. He is a graduate of the Univ ... Show More
25m 13s
Sep 2024
38: Does remifentanil cause opioid-induced hyperalgesia?
Dr. Jess Hawkins joins the show to discuss the literature pertaining to remifentanil and opioid-induced hyperalgesia. Dr. Hawkins is an anesthesia resident at the Massachusetts General Hospital. This podcast was recorded as part of the Depth of Anesthesia podcast elective. Thanks ... Show More
28m 36s
Recommended Episodes
May 2023
May 26 2023 This Week in Cardiology
An HRS meeting recap, Impella failure, sacubitril/valsartan, the purpose of trials, and a major breakthrough in evidence generation are the topics discussed by John Mandrola, MD in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial ... Show More
31m 32s
Aug 2022
Podcast 802: Intranasal Medication Administration for Pediatric Patients
Contributor: Aaron Lessen, MD Educational Pearls: Intranasal medication administration is a convenient, quick, and relatively painless option for pediatric patients Often used as an initial medication to help control pain in children prior to establishing an IV Using an atomizer ... Show More
3m 24s
Mar 2022
REBOOT #151 Anaphylaxis
Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anap ... Show More
40m 49s
Jun 2023
June 16 This Week in Cardiology
AF screening, BNP, a new SGLT2 inhibitor, a sky-is-blue study, and the UK Mini Mitral surgical trial are discussed in this week's podcast This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I ... Show More
27m 59s
Apr 2021
Apr 30, 2021 This Week in Cardiology Podcast
COVID-19 and global vaccinations, AF screening, conduction-system pacing, FDA ban on menthol tobacco, and a heartfelt essay are the topics John Mandrola, MD, discusses in this week’s podcast. https://www.medscape.com/twic COVID-19 Indians Rush for COVID-19 Vaccines as Death Toll ... Show More
23m 3s
May 2023
Podcast 851: High-Dose Nitroglycerin in SCAPE
Contributor: Aaron Lessen MD Educational Pearls: SCAPE (Sympathetic Crashing Acute Pulmonary Edema), formerly known as flash pulmonary edema, is a life-threatening condition due to a sudden sympathetic surge that leads to hypertensive heart failure, pulmonary edema, hypoxia, and ... Show More
3m 8s
Aug 2023
Podcast 866: Carbamazepine (Tegretol) Overdose
Contributor: Aaron Lessen MD Educational Pearls: What is Carbamazepine (Tegretol)? Carbamazepine is an anti-epileptic drug with mood-stabilizing properties that is used to treat bipolar disorder, epilepsy, and neuropathic pain. It functions primarily by blocking sodium channels w ... Show More
2m 46s
Sep 2022
Sept 16, 2022 This Week in Cardiology Podcast
The safety of very low LDL-C, the win-ratio analytic method, sacubitril/valsartan, SGLT2 inhibitors, and percutaneous left atrial appendage closure are discussed in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to ... Show More
23m 37s
Dec 2022
Podcast 839: Causes of Pancreatitis
Contributor: Travis Barlock, MD Educational Pearls: The causes of pancreatitis can be remembered with the mnemonic: “GET SMASHED”  G: Gallstones (Most common cause of pancreatitis overall)  E: Ethanol (Alcohol consumption is the most common cause of chronic pancreatitis) T: Traum ... Show More
3m 21s
Jun 2024
Jun 14 2024 This Week in Cardiology
Listener feedback, statin eligibility and Yogi Berra, evidence-based medicine and heterogenous treatment effects, and MRAs in HF are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial trans ... Show More
30m 52s