We’d have some inquiries about Dr. Forman’s strategy for preventing pain on propofol injection as discussed in episode 18. His approach is anecdotal and hasn’t been formally tested in a clinical trial but might “stand to reason” from a pharmacodynamic and pharmacokinetic perspective. His method is illustrated below.
Attach both lidocaine and propofol syringes.
Inject 1 mg per kg of lidocaine (2%) into IV tubing (deadspace).
Inject propofol to push lidocaine through vein immediately ahead.
Carrier flow pushes remaining propofol through tubing into patient.