Combination of Magnesium and Lidocaine for the Pretreatment of Pain That is Caused by the Injection of Propofol
Condition: General Anesthesia; Intravenous Anesthesia
Intervention: Magnesium Sulfate; Lidocaine; Control; Lidocaine/Magnesium
Intervention description: We propose studying Lidocaine 50 mg in a 10 cc syringe, Magnesium sulfate 0.25 g (2 mOsmol) in a 10 cc syringe, 0.9% saline in a 10 cc syringe, Lidocaine 50 mg and 0.25 g (2 mOsmol) magnesium sulfate in a 10 cc syringe for pretreatment of propofol related pain on injection.; We propose studying Lidocaine 50 mg in a 10 cc syringe, Magnesium sulfate 0.25 g (2 mOsmol) in a 10 cc syringe, 0.9% saline in a 10 cc syringe, Lidocaine 50 mg and 0.25 g (2 mOsmol) magnesium sulfate in a 10 cc syringe for pretreatment of propofol related pain on injection.; We propose studying Lidocaine 50 mg in a 10 cc syringe, Magnesium sulfate 0.25 g (2 mOsmol) in a 10 cc syringe, 0.9% saline in a 10 cc syringe, Lidocaine 50 mg and 0.25 g (2 mOsmol) magnesium sulfate in a 10 cc syringe for pretreatment of propofol related pain on injection.; We propose studying Lidocaine 50 mg in a 10 cc syringe, Magnesium sulfate 0.25 g (2 mOsmol) in a 10 cc syringe, 0.9% saline in a 10 cc syringe, Lidocaine 50 mg and 0.25 g (2 mOsmol) magnesium sulfate in a 10 cc syringe for pretreatment of propofol related pain on injection.
Intervention MeSH terms: Lidocaine; Magnesium Sulfate
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 200.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: Intravenous Anesthesia; General Anesthesia

Summary:

      Since the introduction of propofol into routine anesthesia practice, the phenomena of pain on
      injection has plagued anesthesia providers. Propofol, an unstable phenol, triggers the
      release of bradykinin on injection. This release causes a painful burning sensation in the
      patient at the site of injection. Anesthesia providers have attempted a large number of
      remedies to prevent this pain on injection. Previously explored ideas include injecting
      propofol into larger veins, warming of the hand with hot packs, and intravenous pretreatment
      with numerous other medications. Currently, pretreatment with lidocaine is commonly
      administered to prevent propofol injection pain. No studies to date have looked at the
      combination of lidocaine and magnesium in a single syringe for the pretreatment of pain on
      injection caused by propofol. In addition, the administration protocols that have been
      studied thus far do not mirror clinical practice at the University of Wisconsin. The
      investigators propose studying the use of magnesium and lidocaine in a single syringe for
      pretreatment of propofol related pain on injection.
    

Eligibility criteria:

        Inclusion Criteria:

          -  All adults American Society of Anesthesiologists (ASA) physical status 1 and 2
             patients selected for general anesthesia.

        Exclusion Criteria:

          -  age < 18 years

          -  allergy to local anesthetics

          -  end stage renal disease

          -  pregnancy

          -  prisoners

          -  patients requiring a rapid sequence induction

          -  refusal to participate and patients already participating in another study