Pain Prevention During Propofol Infusion in Pediatric: Hypnoanalgesia of the Hand Versus Lidocaine.
Condition: Pain
Study type: Interventional
Phase: Phase 4

Summary: 
      The simplicity of the implementation and the effectiveness of hypno-analgesia (via the magic
      glove technique) has already been proven in some research work, during the installation of
      peripheral venous route. An unpublished preliminary study has shown that this method appears
      to be the most effective in preventing pain during pediatric propofol injection.

      The purpose is to compare the effectiveness of hypno-analgesia of the hand by the "magic
      glove technique" to lidocaine used in an extemporaneous mixture in the prevention of pain
      with injection of propofol during intravenous induction in children aged 7 to 14 years
    

Detailed description: 
      Propofol is a hypnotic of choice, because of its speed of action, its dose-effect
      relationship (allowing titrated inductions), its anti-emetic effect, as well as its delay and
      its short duration of action. Among its side effects, the pain during its injection occupies
      a significant part in pediatrics (60% in adults, up to 85% in children).

      It is most often described as an unpleasant sensation, discomfort or even a burn at the point
      of puncture, going up along the path of the vein and can extend to the whole arm. The
      mechanism of this pain is still poorly understood at this time. Several mechanisms have been
      mentioned such as activation of the bradykinin cascade, a direct stimulation of the free
      nociceptive venous nerve endings.A meta-analysis concludes in adults that the two most
      effective techniques are a puncture site on the ulnar vein and a pretreatment of the vein by
      Lidocaine. In children, the anatomical differences, the notion of protection of the venous
      capital from the first vascular approach, whatever the prognosis of the patient and the
      competence of the operator will influence the choice of the material, the choice of the site
      and the puncture technique. Several pediatric studies have attempted to reduce this injection
      pain by other techniques. A panel of products has been tested with different drug
      orientations or not. The suggestion centered on analgesia of the hand is a powerful
      technique, adapted to acute pain. The pain sensation will thus be partially or completely
      replaced by a sensation of a different nature, thus attenuating the nociceptive process. This
      technique has not been studied during injection with propofol.
    

Intervention name(s): Magic glove hypnosis technique; lidocaine
Intervention type(s): Procedure; Drug
Intervention description(s): Realization of the magic glove hypnosis technique by an expert physician trained in hypnosis, according to a classic discourse before : intravenous infusion with 1% propofol (3 mg/kg with 600 ml / h electric syringe pump). Use and dose in accordance with the SPC.; intravenous infusion with an extemporaneous mixture of 18 volumes 1% propofol (180mg) for 2 volumes of 1% lidocaine (2ml) with 600 ml / h electric syringe pump. Use and dose in accordance with the SPC.
Intervention MeSH terms: Lidocaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: hypnoanalgesia; lidocaine; propofol; children