Injection pain, cardiovascular changes and recovery following induction of anaesthesia with propofol in combination with alfentanil or lignocaine in children

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Abstract
The effect of pretreatment with alfentanil 10 (Alf10), 15 (Alf15) or 20 (Alf20) μ ˙ kg‐1 on reducing injection pain caused by propofol was compared with lignocaine 10 mg mixed with propofol (Lign). This double‐blind, double‐dummy and randomized study included 100 children with a mean age of 4.3 ± 0.6 years, 25 children in each group, undergoing minor otolaryngological surgery. The children were premedicated orally with midazolam 0.5 mg ˙ kg‐1 and atropine 0.03 mg ˙ kg‐1. Injection pain occurred in 4% in the Lign group. The corresponding figures were 40, 16 and 20% in the Alf10, Alf15 and Alf20 groups, respectively. Both 1% lignocaine 10 mg and alfentanil 15 μg ˙ kg‐1reduced injection pain significantly compared with alfentanil 10 μ ˙kg‐1.Pretreatment with alfentanil significantly diminished haemodynamic responses to tracheal intubation. Furthermore, the concomitant use of alfentanil and propofol caused transient severe bradycardia and a significant decrease in heart rate after laryngoscopy.