***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND This study evaluated a propofol-based anesthesia regimen with spontaneous breathing in pediatric patients scheduled for magnetic resonance imaging ( MRI ) . METHODS In this prospect i ve , r and omized , double-blind study propofol formulated with long-chain triglycerides ( LCT ) and mixed medium-chain/long-chain triglycerides ( MCT/LCT ) were used . Ninety patients aged 2.4 months to 7.3 years were premedicated with intravenous midazolam . Lidocaine was injected prior to propofol to reduce injection pain . Anesthesia was induced and maintained by propofol . Glycopyrronium bromide was administered for saliva reduction . Hemodynamics , blood oxygen saturation and endtidal capnography were continuously monitored . All patients received additional oxygen . The aggregated propofol dose for induction and maintenance of anesthesia was analyzed for therapeutic equivalence . Incidence of injection pain , laboratory safety values , vital signs , and the adverse event profile were analyzed to compare tolerability and safety . RESULTS Propofol anesthesia was safe and successful in all children . Both propofol formulations were equivalent regarding dose requirements ( mean induction and maintenance doses for anesthesia 2.0 - 4.0 mg.kg(-1 ) and 6.0 - 8.8 mg.kg(-1).h(-1 ) respectively ; aggregated doses 8 - 13.26 mg.kg(-1 ) ) . There were no differences in drug safety such as hemodynamics , spontaneous breathing , injection pain , and laboratory values . Duration of induction and of recovery from anesthesia were short and all examinations were completed with minimal interruption . CONCLUSIONS Propofol-based short-term anesthesia was well suited for anesthesia during MRI procedures in the studied pediatric patients . There were no clinical ly relevant differences between the two propofol formulations OBJECTIVE Pain on injection is one of the most described side-effects of the intravenous application of propofol . This study was design ed to assess the efficacy of lidocaine 40 mg in preventing incidence and severity of injection pain for two different propofol solvents . METHODS In a double-blind and prospect i ve study 202 patients were enrolled and r and omized to 4 different groups : group A receiving 2 ml NaCl 0.9 % and propofol-LCT ( Disoprivan ; AstraZeneca ) , group B 40 mg lidocaine and propofol-LCT , group C received 2 ml NaCl 0.9 % and propofol-MCT/LCT ( Propofol-Lipuro , B. Braun Melsungen AG ) and group D 40 mg lidocaine and propofol-MCT/LCT . According to the protocol , all patients were cannulated with a 18-G venous cannula at the dorsum of the h and and no other medicament was injected before the study drug . Time interval between test agents and propofol application in a dosage of 2 mg/kg was one minute . Severity of pain was evaluated during propofol injection over 30 seconds until loss of consciousness using a 4-point rating scale . RESULTS The incidence of injection pain did not differ between propofol-LCT and propofol-MCT/LCT ( 64 % and 53 % ) . Propofol-MCT/LCT significantly reduced the severity of pain compared to propofol-LCT ( p < 0.05 ) . The application of lidocaine result ed in a significant reduction in incidence  ( Propofol-MCT/LCT : 16 % ; Propofol-LCT : 31 % ) and severity of injection pain compared to placebo . CONCLUSION Propofol-MCT/LCT showed a significant advantage compared to propofol-LCT considering the severity of injection pain , but not in reducing the incidence of pain . The use of lidocaine result ed in a significant reduction of incidence and severity of injection pain for both propofol solvents Background : Local pain at the site of intravenous ( iv ) injection of propofol remains a considerable problem in clinical anaesthesiology , and particularly so in infants . The aim of the present study was to compare the influence of two different emulsions of propofol on local pain following iv administration Propofol is widely used for the induction and maintenance of anesthesia , but it often causes local pain when administered into peripheral veins . To prevent this pain , it has been common practice to mix propofol with lidocaine [ 1 ] . Recently , we have demonstrated the effect of nafamostat mesilate ( Torii Pharmaceutical , Tokyo , Japan ) [ 2,3 ] , which is not only a serine protease inhibitor but also a kallikrein inhibitor [ 4 ] , in preventing the pain . The cause of the pain is attributed to the activation of the plasma kallikrein – kinin system by the lipid solvent of propofol , followed by bradykinin generation , which modifies the local vein injected . This modification increases contact between the aqueousphase propofol and the free nerve endings of the vessel , result ing in aggravation of the pain [ 3 ] . Although propofol mixed with nafamostat produced a significant reduction of the pain [ 3 ] , a definitive comparison between propofol mixed with lidocaine and propofol mixed with nafamostat has not yet been undertaken . In this report , we compared the effect of lidocaine and nafamostat in a r and omized , double-blind study . After approval of our institutional committee , 303 elective operative patients classified as ASA physical status 1 or 2 who provided informed consent were allocated in alternate weeks to the lidocaine  ( n 5 153 ) or nafamostat ( n 5 150 ) group . The patients were premedicated with 0.005–0.008mg·kg21 atropine and 0.5– 1.0 mg butorphanol i.m . , 30 min before entering the operating room , where a 20-gauge intravenous catheter was inserted in the forearm . Either 2ml of In a prospect i ve , r and omized study , we investigated the incidence of successful insertion of laryngeal mask airway ( LMA )  at the first attempt and the incidence of side effects after LMA insertion using the combination of sevoflurane and propofol as compared with either sevoflurane or propofol alone for induction of anesthesia . Eighty-three unpremedicated ASA physical status I – II patients were anesthetized with a single vital capacity breath ( VCB ) of sevoflurane 8 % supplemented with IV propofol 1.5 mg/kg , a single VCB of sevoflurane 8 % , or IV propofol 3 mg/kg . The coinduction technique was associated with the most frequent incidence of successful LMA insertion at the first attempt ( 93.5 % ) than either sevoflurane alone ( 46 % ) or propofol alone ( 61.5 % ) ( P < 0.001 ) . Propofol-induced induction of anesthesia allowed the fastest insertion of LMA and was associated with the least frequent incidence of postoperative nausea and vomiting . However , this advantage of propofol was offset by a frequent incidence of pain on injection ( 69 % ) and the occurrence of movements during insertion of the LMA ( 50 % in the propofol group versus 19 % and 26 % in the sevoflurane and sevoflurane-propofol groups , respectively ; P < 0.05 ) , as well as a more frequent incidence of apnea ( 84 % in the propofol group versus 7 % and 16 % in the sevoflurane and sevoflurane-propofol groups , respectively ; P < 0.001 ) . The report shows that induction of anesthesia with sevoflurane-propofol combined provides a frequent incidence of successful LMA insertion at the first attempt that is associated with an infrequent incidence of apnea Pain on injection , reported in 28 - 90 % of patients , is one of the most described side effects of the intravenous application of propofol . Many different approaches have been used in attempts to minimize propofol induced pain , with varied results . Using a r and omized , double-blind protocol design , the author-section pain following the administration of two different particle size formulations of propofol with or without lidocaine in 388 nonpremedicated ASA I-II adult patients scheduled for elective surgery under general anesthesia . Patients were allocated r and omly to receive either a small particle size lipid emulsion of propofol ( Anepol : average particle size 140.5 nm ) , or st and ard propofol ( Propofol : average particle size 193.3 nm ) , by dividing into 4 groups . Group 1 received 2 ml NaCl 0.9 % and Propofol , group 11 received 2 ml lidocaine 2 % and Propofol , group III received 2 ml NaCl 0.9 % and Anepol and group IV received 2 ml lidocaine 2 % and Anepol into a dorsal vein of the h and . Pain during propofol injection was evaluated over 5 - 10 seconds , until loss of conscious , using a four point scale . Sixty-seven patients ( 69.1 % ) complained of pain in group 1 , as compared with 50 % , 41.2 % and 39.2 % in group II , III and IV ( p < 0.05 ) . The reported severity of injection pain was not significantly different between the groups . The authors conclude that small particle size propofol causes less pain on injection than st and ard propofol Background : Propofol , a popular intravenous ( iv ) anaesthetic induction agent for brief cases or day surgery , is associated with smooth induction , pleasant sleep , rapid recovery and little postoperative nausea . A major disadvantage is pain at the site of injection . The aim of the present study was to examine the influence of simultaneous iv infusion of carrier fluid on propofol‐induced local pain Forty patients undergoing vaginal termination of pregnancy were r and omly allocated to receive a propofol anaesthetic using either a repeat bolus or infusion technique . The Ohmeda 9000 Infusion Pump was used in the study . Patients in the infusion group recorded significantly longer induction times , greater maintenance doses and prolonged immediate recovery characteristics . Both techniques offered cardiovascular stability but no advantages were demonstrated for the infusion technique over a conventional repeat bolus method Purpose Young age is considered as one of the factors associated with emergence agitation ( EA ) following sevoflurane anesthesia . The relationship between EA following propofol anesthesia and young age has not yet been examined . This study was design ed to compare the incidence of EA in younger children and older children following either propofol or sevoflurane anesthesia .  Methods Ninety-six preschool-aged ( 2–5 years ) children and 90 school-aged ( 6–11 years ) children ( American Society of Anesthesiologists [ ASA ] I or II ) scheduled to undergo otorhinolaryngological surgery were r and omly assigned to receive either propofol or sevoflurane .  These children were divided into the following four groups : propofol-preschool ( P-pre ) , sevoflurane-preschool ( S-pre ) , propofol-school ( P-school ) , and sevoflurane-school ( S-school ) groups . Recovery times and incidence of EA were compared among the four groups . Results We observed that the recovery times were similar in the four groups . After extubation , the incidence of EA in the S-pre group was significantly higher than that in the other groups . After eye opening , the incidence of EA in the S-pre and S-school groups was significantly higher than that in the P-pre or P-school groups . At all recovery times , no difference was observed in the incidence of EA between the P-pre and P-school groups . Conclusion Propofol , in comparison with sevoflurane , result ed in a lower incidence of EA , with no relation to age This was a r and omized study of 180 ASA physical status I and II patients , 60 in each group who received propofol ( PROP ) , 2.5 mg·kg-1 , thiopentone ( THIO ) , 4 mg·kg-1 , or methohexitone ( METH )  , 1.5 mg·kg-1 . Control values , followed by changes after induction and during a 3-min delay before intubation were recorded for the following parameters : heart rate ( HR ) , systolic and diastolic blood pressures ( SBP , DBP ) , respiratory rate ( RR ) , end — tidal CO2 ( PetCO2 ) , and induction time ( IT ) . In addition , the incidence of adverse reactions and time for recovery from anaesthesia were noted . The IT ( mean ± SE ) was 35 ± 1 sec for propofol , 35 ± 1.2 sec for thiopentone and 34 ± 1.4 sec for methohexitone . Ninety-three per cent of the PROP group fell asleep with one dose and required no additional doses . Fifty per cent of each of the THIO and METH groups required additional agents ( p < 0.05 ) . METH was associated with the highest elevation in HR , PROP the least ( p < 0.05 ) . PROP was associated with the most decrease in SBP and DBP and in addition respiratory depression ( p < 0.05 ) . The incidence of injection pain or excitatory activity was equal in the three groups with the exception that 14 patients who received METH developed hiccoughs while none did in the other groups . PROP was associated with the most rapid recovery , particularly with respect to the orientation time . We conclude that PROP is an effective alternative to barbiturate induction and that the published recommended doses of 
    Output:
    
Statistical testing of indirect comparisons showed that use of the antecubital vein and pretreatment using lidocaine along with venous occlusion to be more efficacious than the other interventions .
The two most efficacious interventions to reduce pain on injection of propofol were use of the antecubital vein , or pretreatment using lidocaine in conjunction with venous occlusion when the h and vein was chosen .