Lidocaine In Children Research Articles

Split-mouth Comparison of Anesthetic Efficacy of Articaine and Lidocaine for Extractions of Deciduous Maxillary Teeth: A Randomized Controlled Trial.

To clinically evaluate whether 4% articaine administered alone as a single buccal infiltration in deciduous maxillary tooth extraction can provide favorable palatal anesthesia compared to buccal and palatal infiltrations using 2% lidocaine. A prospective, double-blind, split-mouth, randomized controlled clinical study was carried out on 60 children comprising 36 females and 24 males in the age group of 5-10 years. During two separate appointments, children randomly received either 4% articaine with 1:1,00,000 epinephrine (group I-experimental) as buccal infiltration alone, or 2% lidocaine with 1:80,000 epinephrine (group II-control) as buccal plus palatal infiltration. Second local anesthetic agent was administered at least 1 week apart from first administration. Efficacy of anesthesia was assessed using subjective [Wong-Baker Faces Pain Scale (WBFPS)] and objective [sound, eye, motor (SEM)] scales along with occurrence of any adverse effects. For infiltration procedure, 4% articaine (group I) had statistically highly significant (p < 0.001) pain scores on WBFPS as well as on SEM scale compared to 2% lidocaine (group II). According to WBFPS (p = 0.43) and SEM (p = 0.32) scores, the pain on extraction between 4% articaine and 2% lidocaine was statistically insignificant. About 4% articaine buccal infiltration showed better clinical anesthetic efficacy, thus providing effective palatal anesthesia due to its enhanced vestibule-palatal diffusion with no significant postanesthetic complications. Hence, articaine can be used as an alternative to lidocaine in children for extractions of deciduous maxillary teeth. Jankar JL, Pustake BJ. Split-mouth Comparison of Anesthetic Efficacy of Articaine and Lidocaine for Extractions of Deciduous Maxillary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2024;17(S-1):S6-S10.

Evaluation of the onset of pulpal, soft tissue anesthesia, and pain using buffered lidocaine in children: a randomized-controlled trial

The American Academy of Paediatric Dentistry (AAPD) has recently released guidelines that highlight the importance of conducting further research on the effects of buffered local anesthesia in children. Adjusting the pH of local anesthetics may reduce pain and reduce the onset time of anaesthesia. In this study, we evaluated the onset of pulpal, soft tissue anesthesia and pain during inferior alveolar nerve block injection to treat pulpally involved mandibular primary molars with buffered lidocaine in comparison with non-buffered lidocaine. We conducted a prospective, randomized, triple-blind, crossover trial involving 40 children aged 7 to 10 years. The onset time of soft tissue anaesthesia was assessed by probing the gingiva after ensuring numbness of the tongue, the lower lip, and the angle of the mouth, while the onset time for pulpal anaesthesia assessed using Endo-ice. We identified a significant difference between buffered lidocaine and non-buffered lidocaine in the onset time of pulpal and soft tissue anesthesia (p &lt; 0.001). Analysis also identified a showed a significant difference between the two groups for the Wong-Baker Faces pain rating scale (p &lt; 0.006) and the Sound, Eye and Motor scale (p &lt; 0.043). In conclusion, buffered lidocaine reduced the onset time for anaesthesia in pulpal and soft tissue, and reduced pain during the administration of inferior alveolar nerve block injections in children. According to the findings of this study, buffered lidocaine can be utilized as an alternative to non-buffered lidocaine in children.

English

BACKGROUND The incidence of pain on propofol injection varies between 28 – 90 % during induction and may be severe. Ramosetron has been proved efficacious in reducing propofol pain in adults but not in children, therefore we conducted this double blinded randomized controlled study to determine the effectiveness of ramosetron in attenuating propofol induced pain in children. The purpose of this study was to compare the effectiveness of injection ramosetron, a 5HT3 antagonist and lidocaine, the commonest drug for attenuation of pain caused by injection propofol. METHODS This is a randomised double-blinded study. Eighty children of American Society of Anaesthesiologist (ASA) grade I - II, aged 4 - 14 years, undergoing elective surgical procedures under general anaesthesia were randomly assigned to two groups of 40 each. Group PR received 6 µg/kg of ramosetron and Group PL received 0.2 mg/kg of 2 % lidocaine. After injection of study drug, occlusion of venous drainage was done manually by a trained assistant at mid-arm for 60 seconds. After releasing manual occlusion Injection propofol (1 %) 2 mg/kg was administered slowly over a period of 5 seconds. A four point scale was used to assess the severity of pain. The results were analysed by using unpaired student’s t - test and chi-square test/Fisher’s exact test. P value of &lt; 0.05 was considered statistically significant. RESULTS The demographic characteristics were comparable in both groups. The incidence of no pain in Group PR and Group PL was 60 % (N = 24) and 65 % (N = 26) respectively which was comparable. The incidence of mild, moderate and severe pain was comparable in both groups. The overall incidence of propofol injection pain in group PL and group PR was 35 % and 40 % respectively (P = 0.862). CONCLUSIONS Intravenous ramosetron at a dose of 6 µg/kg can effectively attenuate the propofol induced pain comparable to 0.2 mg/kg of lidocaine in children. KEYWORDS Children, Lidocaine, Propofol Induced Pain, Ramosetron

Efficacy and safety of intravenous infusion of lidocaine in children

Efficacy and safety of intravenous infusion of lidocaine in children

Small trial does not find differences between articaine and lidocaine in children undergoing primary molar extraction

Small trial does not find differences between articaine and lidocaine in children undergoing primary molar extraction

Comparing the Hemodynamic Effects of Nebulized Dexmedetomidine and Nebulized Lidocaine in Children undergoing Fiberoptic Bronchoscopy

Comparing the Hemodynamic Effects of Nebulized Dexmedetomidine and Nebulized Lidocaine in Children undergoing Fiberoptic Bronchoscopy

Intravenous Lidocaine in Children Undergoing Laparoscopic Appendectomy

Intravenous Lidocaine in Children Undergoing Laparoscopic Appendectomy

Comparing the Hemodynamic Effects of Nebulized Dexmedetomidine and Nebulized Lidocaine in Children undergoing Fiberoptic Bronchoscopy

Background and Objective: Several studies have shown that topical and intravenous Dexmedetomidine and Lidocaine can decrease pain and reduce consumption of analgesic drugs. However, Lidocaine may be accompanied with several side effects such as respiratory suppression, seizure, and cardiac arrhythmias. On the other hand, Dexmedetomidine has favorable properties such as low risk of apnea, analgesia, sympatholysis, and sedation. Therefore, the aim of this study was to compare the effects of nebulized Dexmedetomidine and nebulized Lidocaine on hemodynamic characteristics of the patients undergoing bronchoscopy. Materials and Methods: In the present randomized, double-blind study; 75 children (1-6 years old) undergoing fiber-optic bronchoscopy were allocated to three groups. Group 1 received nebulized solution containing 2 µg/kg of Dexmedetomidine. Group 2 received nebulized solution containing 4 mg/kg of Lidocaine 1. Group 3 received nebulized solution containing 0.9 of normal saline as the control group. Heart rate, mean arterial blood pressure and SpO2, Bispectral Index (BIS) were measured and compared. BIS, indicating the depth of anesthesia was considered as a confounding factor. Statistical analysis was performed using SPSS software. Results: The mean of arterial blood pressure and heart rate was significantly lower in group 1 compared to groups 2 and 3 during bronchoscopy (P< 0.05). Blood oxygen saturation and sedation scores were significantly higher in group 1 compared to the other groups during bronchoscopy (P< 0.05). Furthermore, the hemodynamic parameters were more stable in group 1 compared to the other groups during recovery. Conclusion: Premedication with nebulized Dexmedetomidine was significantly associated with more stable hemodynamic parameters and lower risk of side effects compared to nebulized Lidocaine in children undergoing fiberoptic bronchoscopy.

Factors associated with intravenous lidocaine in pediatric patients undergoing laparoscopic appendectomy \u2013 a retrospective, single-centre experience

BackgroundDue to its potential beneficial effects, intra- and postoperative application of intravenous lidocaine has become increasingly accepted over the last couple of years, e.g. in patients undergoing laparoscopic surgical procedures. Based on its beneficial properties, lidocaine was introduced to the standard of care for all pediatric laparoscopic procedures in our institution in mid-2016. In contrast to adult care, scarce data is available regarding the use of perioperative intravenous lidocaine administration in children undergoing laparoscopic procedures, such as an appendectomy.MethodsRetrospective analysis of all pediatric patients undergoing laparoscopic appendectomy at the University Children’s Hospital Zurich in 2016. Perioperative data, as recorded in the electronic patient data management system, were evaluated for any signs of systemic lidocaine toxicity (neurological and cardiovascular), behavioral deterioration, as well as for hemodynamic instability. Additionally, the incidence of postoperative nausea and vomiting, administration of pain rescue medication, time to hospital discharge and to first bowel movement, as well as any postoperative complications were recorded. Starting on 01/07/2016, all patients undergoing laparoscopic surgery received intravenous lidocaine (1.5 mg/kg body weight (BW) bolus after induction of anesthesia followed by continuous infusion of 1.5 mg/kgBW/h). These patients were then compared to children without lidocaine administration who had undergone laparoscopic appendectomy between 01/01/2016 and 30/06/2016.ResultsData of 116 patients was analyzed. Of these, 60 patients received lidocaine. No signs of systemic toxicity, neurologic impairment or circulatory disturbances were noted in any of these patients. A (non-significant) difference in the incidence of emergence delirium was observed (0 cases in the lidocaine group vs. 4 cases in the control group, p = 0.05).ConclusionThis retrospective analysis did not reveal any adverse effects in pediatric patients receiving intravenous lidocaine for laparoscopic appendectomy under general anesthesia. However, further trials investigating beneficial effects as well as pharmacokinetic properties of intravenous lidocaine in children are required.

The Editor recommends this issue's article to the reader

International Journal of Paediatric DentistryVolume 28, Issue 4 p. 346-346 Editor's Choice The Editor recommends this issue's article to the reader Anaesthetic efficacy of Articaine versus Lidocaine in children's dentistry: a systematic review and meta-analysis First published: 21 June 2018 https://doi.org/10.1111/ipd.12376Citations: 1 This logo highlights the Editor's Choice articles in the table of contents and the first page of each of the articles. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume28, Issue4July 2018Pages 346-346 RelatedInformation

Anaesthetic efficacy of articaine versus lidocaine in children's dentistry: a systematic review and meta-analysis.

Over the last few years, numerous reviews and studies have awarded articaine hydrochloride local anaesthetic (LA) a superior reputation, with outcomes of different studies demonstrating a general tendency for articaine hydrochloride to outperform lidocaine hydrochloride for dental treatment. Nevertheless, there seems to be no clear agreement on which LA solution is more efficacious in dental treatment for children. There is no previous publication systematically reviewing and summarising the current best evidence with respect to the success rates of LA solutions in children. To evaluate the available evidence on the efficacy of lidocaine and articaine, used in paediatric dentistry. A systematic search was conducted on Cochrane CENTRAL Register of Controlled Trials, MEDLINE (OVID; 1950 to June 2017), Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCOhost; 1982 to June 2017), EMBASE (OVID; 1980 to June 2017), SCI-EXPANDED (ISI Web of Knowledge; 1900 to June 2017), key journals, and previous review bibliographies through June 2017. Original research studies that compared articaine with lidocaine for dental treatment in children were included. Methodological quality assessment and assessment of risk of bias were carried out for each of the included studies. Electronic searching identified 525 publications. Following the primary and secondary assessment process, six randomised controlled trials (RCT) were included in the final analysis. There was no difference between patient self-reported pain between articaine and lidocaine during treatment procedures (SMD = 0.06, P-value = 0.614), and no difference in the occurrence of adverse events between articaine and lidocaine injections following treatment in paediatric patients (RR = 1.10, P-value = 0.863). Yet, patients reported significantly less pain post-procedure following articaine injections (SMD = 0.37, P-value = 0.013). Substantial heterogeneity was noted in the reporting of outcomes among studies, with the overall quality of majority of studies being at high risk of bias. There is low quality evidence suggesting that both articaine as infiltration and lidocaine IAD nerve blocks presented the same efficacy when used for routine dental treatments, with no difference between patient self-reported pain between articaine and lidocaine during treatment procedures. Yet, significantly less pain post-procedure was reported following articaine injections. There was no difference in the occurrence of adverse events between articaine and lidocaine injections following treatment in paediatric patients.

The safety of a mixture of bupivacaine and lidocaine in children after urologic inguinal and scrotal surgery.

PurposeLocal anesthetic agents such as bupivacaine and lidocaine are commonly used after surgery for pain control. The aim of this prospective study was to evaluate the safety of a mixture of bupivacaine and lidocaine in children who underwent urologic inguinal and scrotal surgery.Materials and MethodsFifty-five patients who underwent pediatric urologic outpatient surgeries, were prospectively enrolled in this study. The patients were divided into three groups according to age (group I: under 2 years, group II: between 3−4 years, and group III: 5 years and above). Patients were further sub-divided into unilateral and bilateral groups. All patients were injected with a mixture of 0.5% bupivacaine and 2% lidocaine (2:1 volume ratio) at the surgical site, just before the surgery ended. Hemodynamic and electrocardiographic parameters were measured before local anesthesia, 30 minutes after administration of local anesthesia, and 60 minutes after administration.ResultsThe patients' mean age was 40.5±39.9 months. All patients had normal hemodynamic and electrocardiographic parameters before local anesthesia, after 30 minutes, and after 60 minutes. Also, results of all intervals were within normal values, when analyzed by age and laterality. No mixture related adverse events (nausea, vomiting, pruritus, sedation, respiratory depression) or those related to electrocardiographic parameters (arrhythmias and asystole) were reported in any patients.ConclusionsA mixture of bupivacaine and lidocaine can be safely used in children undergoing urologic inguinal and scrotal surgery. An appropriate dose has no clinically significant hemodynamic or cardiac changes and adverse effects.

Comparison of Visual Analog Scale Scores in Pain Assessment during Pulpotomy using Different Injection Materials in Children Aged 6 to 8 and 8 to 10 Years

Proper anesthesia and pain management during treatment are most important concerns in dentistry for people of all ages, especially children. This study compared the success rate of lidocaine block with articaine buccal infiltration during anesthesia of the primary mandibular second molars in children aged 6 to 8 and 8 to 10 years. The present clinical trial was conducted on 40 children aged 6 to 8 and 8 to 10 years who were referred to the Department of Pediatrics of the Faculty of Dentistry at Shahid Sadoughi University of Medical Sciences in Yazd (Islamic Republic of Iran) and needed to be treated with pulpotomy on both primary mandibular second molars. The patients were randomly divided into two groups. At the first session, a group received articaine buccal infiltration and the other group experienced inferior alveolar nerve (IAN) block. At the next visit, this trend was reversed. Visual analog scale (VAS) was used to evaluate the pain during pulpotomy. Data were analyzed by Statistical Package for the Social Sciences (version 17) software using Mann-Whitney test. According to the results of this test, the pain during pulpotomy was significantly lower in the articaine group (p < 0.001). Articaine buccal infiltration can be employed for pulpotomy treatment in primary mandibular second molars. This research will eliminate block injection of lidocaine in children and utilize infiltration of articaine for pulpotomy treatment of mandibular teeth, hence preventing lingual nerve damage and prolonging paresthesia of IAN, lip, and cheek bite due to IAN block anesthesia.

Comparative evaluation of the efficacy of 4% articaine and 2% lidocaine in children during the primary maxillary molar extractions

Aims: This study aims to compare and evaluate the efficacy of 4% articaine and 2% lidocaine in children during the primary maxillary molar extractions. Materials and Methods: A total of 102 patients were randomly selected for the study who required maxillary molar extractions and received buccal infiltration either using lidocaine or articaine. Results: Higher mean value for facial pain scale for lidocaine suggesting lesser effectiveness of infiltration was seen in the results. Statistically insignificant changes were seen in heart rate, blood pressure, and difference in Face, Legs, Activity, Cry, and Consolability Scale between articaine and lidocaine. Higher pain scores with lidocaine compared to articaine are shown in the results of the study but are not statistically significant. Conclusions: It can be concluded that articaine is better alternative to lidocaine for local anesthesia in pediatric patients.

Topical Versus Intravenous Lidocaine in Children With Upper Respiratory Infection Undergoing Anesthesia: A Randomized, Double Blind, Clinical Trial.

Background:The current randomized double-blind clinical trial aimed to compare the incidence of post-operative cough with intravenous vs. topical lidocaine in children with mild upper respiratory infection (URI) anesthetized with laryngeal mask airway (LMA) in the university-affiliated medical center.Objectives:To assess the incidence of adverse respiratory event including cough, apnea, laryngospasm, bronchospasm following two different methods of lidocaine administration in anesthetized children with mild URI.Patients and methods:One hundred and thirty pediatric patients with mild URI (within the previous two weeks) aged between one and six years were enrolled. They were candidates to undergo immediate full ophthalmic examination, and randomly divided into two groups of 65to receive intravenous (1.5 mg/kg) or topical lidocaine on LMA. Anesthesia was induced with sevoflurane, subsequently LMA was inserted when the patient was in deep anesthesia status and maintained on (50% N2O, 50% O2) and 3% sevoflurane. Spontaneous ventilation was maintained throughout the procedure and LMA was removed in deep anesthesia. Outcomes (cough, laryngospasm, bronchospasm and vomiting) were evaluated peri-operatively and one day post-operation.Results:One hundred and twenty four patients fulfilled the trial. Cough (primary outcome) was significantly more frequent among those with topical compared with intravenous lidocaine (46% vs. 26%; P = 0.004). The incidence of laryngospasm (32% vs. 27%), bronchospasm (18% vs. 12%), desaturation (18% vs. 12%) and vomiting (5% vs. 2%) was not statistically different between the groups.Conclusions:The pediatric patients undergoing general anesthesia with LMA with intravenous lidocaine experienced fewer incidence of postoperative cough compared to the ones in the topical lidocaine group.

Status Epilepticus, Cardiac Resuscitation, and Posterior Reversible Encephalopathy Syndrome After Ingestion of Viscous Lidocaine

Ingestion of viscous lidocaine in children can lead to potentially lethal neurologic and cardiac effects. We report the case of a 2-year-old boy who developed posterior reversible encephalopathy syndrome 2 days after unobserved ingestion of about 500 mg viscous lidocaine (40 mg/kg of bodyweight). Initially, the child presented with convulsive status epilepticus and subsequent cardiac arrest necessitating cardiopulmonary resuscitation for eight minutes. After 2 days of full recovery, the child presented with progressive disorientation, dizziness, and visual neglect. Lasting for 2 days, these symptoms finally disappeared completely. Combined with the findings on cerebral magnetic resonance imaging, this episode was interpreted as posterior reversible encephalopathy syndrome. Two weeks after the ingestion, no neurologic and visual abnormalities were found. Viscous lidocaine is prescribed routinely for dentition or other painful lesions in the oral cavity in children. Despite the potential hazardousness of the drug, packaging of viscous lidocaine is not childproof. Therefore, physicians have to instruct the parents carefully to minimize the risk of overuse or accidental ingestion. In general, the use of viscous lidocaine should be limited.

Pain on injection with propofol

The use of propofol often results in pain on injection, which is sometimes very distressing to patients. In analysis of 6,264 patients in 56 reports, 70% of all control patients reported some degree of pain or discomfort on injection with propofol [1]. In 1998, Tan and Onsiong [2] suggested that a wise choice would be to use a combination of techniques, such as alfentanil pretreatment, mixing lidocaine with the propofol and injecting into a large vein with no carrier fluid to decrease the incidence and severity of propofol injection pain. McCrirrick and Hunter [3] found that administering propofol at 4℃, significantly reduces the incidence of injection pain. Prior injection of cold saline reduces the incidence of pain and discomfort significantly compared with unmodified propofol and is similar to that after cold propofol and propofol with lidocaine [4]. However, the incidence of pain with cold propofol and lidocaine is not statistically different from room temperature propofol and lidocaine in children [5]. Cho et al. [6] assessed the effectiveness of cold propofol and pretreatment with remifentanil in minimizing pain associated with the injection of propofol and investigated whether a combination of cold propofol and remifentanil produced additional analgesic efficacy. They found that a combination treatment with 0.5 µg/kg remifentanil pretreatment and cold propofol significantly reduces the incidence and severity of propofol injection pain compared with each treatment used alone. The aqueous phase, which contains free propofol, is known to be associated with the intensity of pain at the injection site. Yamakage et al. [7] recommended the use of propofol medium-chain triglyceride (MCT)/long-chain triglyceride (LCT) for reducing pain on injection, because the concentrations of free propofol are significantly smaller by 30-45% than those in propofol LCT. Mallick et al. [8] reported that premixing 40 mg of lidocaine to Lipuro® propofol (a propofol formulated as an emulsion of 50% MCT and 50% LCT) almost abolishes the pain on injection, making induction of anesthesia less painful compared to Lipuro® propofol alone or Diprivan® propofol (a propofol formulated as an emulsion in a solution of 10% soybean oil containing only LCT) with lidocaine. A lipid-free microemulsion propofol (Aquafol®) was developed to avoid the risk of lipid solvent-related adverse drug reactions, and the efficacy and safety are not different from those of Diprivan® [9]. Microemulsion propofol produces more frequent and severe pain on injection than lipid emulsion propofol, a difference that may be attributable to the seven-fold higher concentration of aqueous free propofol [10]. Kim et al. [11] investigated the effect of a lidocaine mixture on microemulsion propofol injection pain and sought to determine the optimal dose of lidocaine that reduced pain on injection of propofolidocaine mixture. They used 20, 30, and 40 mg lidocaine, and the incidence of pain was 80%, 65%, and 50%, respectively, compared with 97.5% in a control group. Within this lidocaine dose range, increasing the lidocaine dose significantly lessened the pain during injection of microemulsion propofol. However, it is difficult to conclude that 40 mg of lidocaine is an optimal dose because a 50% incidence of injection pain is too high. Although several single or combination methods with lipid emulsion propofol nearly abolish pain on injection, further studies to search for an effective and safe method to reduce pain on injection, especially with microemulsion propofol, are needed until a better and safer propofol is available for clinical use in the near future.

Avoiding propofol injection pain in children: a prospective, randomized, double-blinded, placebo-controlled study

BackgroundPain on injection limits the use of propofol in children. The combination of lidocaine and propofol is widely used to reduce pain. A new solvent [medium-chain triglyceride (mct)/long-chain triglyceride (lct)] has been advocated to be less painful than standard (lct) propofol in adults, but no information is available of its usefulness in pre-school children. We designed a prospective, randomized, double-blinded, placebo-controlled study to assess injection pain with two different propofol emulsions, each given with or without lidocaine in children <7 yr. MethodsA total of 160 ASA I–III children were randomly assigned to receive lct–propofol or mct/lct–propofol, 5 mg kg−1, with lidocaine 10 mg ml−1 or saline. The site and size of venous cannulation and restlessness before injection were recorded in each patient. A pain score graded 0–6 was established based on spontaneous verbal and motor reaction during injection, each graded 0–3. Kruskall–Wallis and Mann–Whitney tests were used for statistical analysis. ResultsMedian pain scores decreased in all groups compared with lct–propofol–saline (P<0.001) and were least in the lct/mct–propofol–lidocaine group (P<0.001). Painless injection (score, 0–2) occurred in 92.5% of patients in the mct/lct–propofol–lidocaine group compared with 41–77% in the others (P<0.001). ConclusionsMct/lct–propofol caused significantly less pain than lct–propofol in preschool children. Mixing of lidocaine with mct/lct–propofol resulted in a further significant decrease, virtually eliminating the pain on injection.

Laryngospasm is depressed by intravenous lidocaine in children anaesthetized with sevoflurane

Laryngospasm is depressed by intravenous lidocaine in children anaesthetized with sevoflurane

Etomidate-®Lipuro is associated with considerably less injection pain in children compared with propofol with added lidocaine

Propofol is associated with a high incidence of injection pain in children, even if given together with lidocaine. A new lipid formulation of etomidate (Etomidate-Lipuro) has been found in adults to cause very little discomfort during i.v. injection. The aim of the present prospective, double-blind, randomized trial was to compare the incidence of injection pain during i.v. induction of anaesthesia between propofol with added lidocaine (previous standard) and this new etomidate formulation in paediatric patients. A total of 110 paediatric patients, aged 2-16 years, scheduled for outpatient surgery were planned to be included in the study. The primary end point of the study was the incidence of injection pain during induction of anaesthesia as assessed by a four-point scale as described previously. The occurrence of myoclonic muscular activity was registered as a secondary end point (four-point scale). An interim analysis after 80 patients was requested by the Ethics' Committee. The study was stopped after the inclusion of 80 patients. A significantly lower incidence of injection pain was found in the Etomidate-Lipuro group as compared with the propofol-lidocaine group (5.0% vs 47.5%, P<0.001). The use of etomidate was associated with a significantly higher incidence of myoclonic activity compared with propofol-lidocaine (85.0% vs 15%, P<0.001). The use of a new lipid formulation of etomidate is associated with significantly less injection pain than propofol with added lidocaine in children. This finding may warrant a change in clinical practice in order to avoid unnecessary pain in children.