Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A possible misidentified role of propofol (original) (raw)
Related papers
Post-Operative Effects: Comparison of Total Intravenous and Inhalational Anesthesia
Journal of Anesthesia & Clinical Research, 2012
Background: Propofol is an intravenous anesthetic with known antiemetic properties. Less confirmed are its potential analgesic or antinociceptive postoperative effects when used as a maintenance anesthetic during surgery. We compared the postoperative effects of total intravenous anesthesia (TIVA) with propofol to those of inhalational anesthesia with sevoflurane and looked for differences in the quality of recovery of patients. Methods: We studied 23 patients scheduled to undergo endoscopic sinus surgery (ESS). Using a doubleblind experimental method, we randomly assigned patients to receive either TIVA with propofol/remifentanil (PR) or inhalational anesthesia with sevoflurane/remifentanil (SR). We measured degree of pain (per visual analog scale where 1=no pain and 10=worst pain imaginable), incidence of nausea and vomiting, and duration of recovery postoperatively. Results: Mean pain rating was 3.4±3.3 in the PR group and 5.3±2.8 in the SR group. Median pain rating was 3±3 in the PR group and 5.5±1.5 in the SR group. In the PR group, 3 out of 12 patients reported a pain score > 4; In the SR group, 6 out of 10 patients reported a pain score > 4. Only 1 incidence of nausea was reported per group. Narcotics administered were comparable between both groups. Mean recovery time was 67±30 minutes in the PR group and 69±27 minutes in the SR group. Conclusion: We found no statistically significant difference between TIVA with propofol and inhalational anesthesia with sevoflurane as they relate to postoperative pain, nausea and vomiting, narcotic administration, and recovery time. J o u rn al of A n e s th es ia & C li n ic a l Resea rc h
Anaesthesia, 1997
Eighty patients undergoing lower third molar surgery under general anaesthesia were assigned to one of two groups to receive local anaesthetic blockade either 10 min prior to surgery or after surgery just before leaving the operating theatre. Patients in both groups received the local anaesthetic block whilst unconscious. Pain was assessed using visual analogue scales at 6 h and 1, 3 and 6 days after surgery. A McGill Pain Questionnaire was also completed on the morning following surgery. At no time was it possible to detect any significant difference in pain between the two groups. The administration of local anaesthesia prior to starting surgery does not appear to have any advantage over its postoperative administration in patients undergoing this type of surgery. The local anaesthetic, however, does provide excellent analgesia during the first few hours following surgery.
Journal of Pain Research
Backgrounds and objective: Some studies have shown that deeper anesthesia is more effective on postoperative analgesia and reduces the need for sedative drugs. This study sought to investigate the effect of depth of anesthesia on postoperative pain in laparoscopic cholecystectomy. Materials and methods: In this double-blind clinical trial, 60 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups: low bispectral index (L-BIS=35-44) and high bispectral index (H-BIS=45-55). Anesthesia protocol was the same for both groups (propofol and remifentanil). The pain intensity (at rest and during cough) was evaluated based on the visual analog scale scores in recovery and at 8, 16 and 24 hours after surgery. Results: The mean pain score was significantly lower in patients in the L-BIS group at all examined times at rest and during cough than that in the H-BIS group. The number of patients in need of additional sedative drug in the H-BIS group in recovery was significantly more than that in the L-BIS group (27 vs 18 patients, P=0.007). The incidence of nausea in the recovery room 8 hours after the surgery was significantly less in the L-BIS group than that in the H-BIS group, while at 16 and 24 hours, no case of nausea was reported in the two groups. Conclusion: Given the results of this study, it seems that general anesthesia with propofol and remifentanil with L-BIS causes less need for additional analgesic drug and less nausea and vomiting compared to anesthesia with H-BIS.
OBJECTIVE: The aim of this study was to determine the effects of total intravenous anesthesia with propofol and fentanyl compared with those of isoflurane and fentanyl on recovery characteristics, postoperative nausea and vomiting (PONV) and duration of hospitalization. METHODS: Patients classified as ASA status I or II undergoing elective short surgical procedures, with duration up to one hour were enrolled in the study. Patients were randomly assigned at a 1:1 ratio to receive total intravenous anesthesia with propofol (1.5–2.0 mg/kg) and fentanyl (1.5 μg/kg) or isoflurane (0.8%–1.2%), nitrous oxide and fentanyl (1.5 μg/kg). Extubation time, recovery time, PONV, postoperative antiemetic requirement and duration of hospitalization were recorded. Results: 120 patients completed the study. Recovery time was significantly shorter in the propofol group (n = 60) compared with the isoflurane group (n = 60) (7.0 [0.77] vs 8.5 [0.66] min, respectively; P< 0.005). In the propofol group, significantly fewer patients had vomiting episodes compared with those in the isoflurane group (4 [6.7%] vs 32 [53.3%]; P< 0.005). The duration of hospitalization after surgery was significantly shorter in the propofol group than in the isoflurane group (22.60 [3.6]vs. 25.5 [4.1]hours; P = 0.0001). CONCLUSION: Total intravenous anesthesia with propofol and fentanyl was associated with a significantly reduced rate of PONV , shortened recovery time and duration of hospitalization, compared with isoflurane and fentanyl in these patients undergoing surgery up to one hour .
Scholars journal of applied medical sciences, 2020
Original Research Article Introduction: Propofol is a short-acting medication that results in a loss of consciousness and lack of memory for events. Sevoflurane is a sweet-smelling, nonflammable, highly fluorinated methyl isopropyl ether used as an inhalational anaesthetic for induction and maintenance of general anesthesia. We have a very few comparative data regarding these two anaesthetic agents. Aim of the study: The aim of this study was to compare the postoperative complications between "total intravenous anesthesia with propofol" and "sevoflurane inhalation anesthesia". Methods: This retrospective study was conducted in Pioneer Hospital, Chattogram, Bangladesh. During the period from January 2018 to December 2018. In total 94 patients who had ENT surgeries previously were finalized as the total study population. Total patients were divided into 2 groups. In Group I there were 43 patients to whom total intravenous anesthesia with propofol (TIVA) had been used and in Group II there were 51 patients to whom sevoflurane inhalation anesthesia (SIA) had been used. Postoperative complications and recovery period were determined as tachycardia, bradycardia, hypertension, hypotension, recovery time, additional analgesia and nausea-vomiting. Result: For the patients who had surgeries under TIVA, the additional analgesia and nausea-vomiting incidences were found as 23.26% and 20.93% respectively and the recovery period was 12 minutes. On the other hand, for the patients who had surgeries under SIA, the additional analgesia and nauseavomiting incidences were found as 19.61% and 33.33% respectively and the recovery period was 8 minutes. Conclusion: Due to retrospective nature of this study, results were depended on the records of patient's files only and it was a limitation of this study. According to the analysis of complications regarding two different procedures we found near about the similar performance. Although there was a difference between the lengths of recovery time but that doesn"t a big issue to differ among the procedures. As it was a single centered study with some unavoidable limitations, to get more specific information we would like to recommend for conducting more studies in several places.
Advanced biomedical research, 2014
Laryngoscopy and endotracheal intubation can induce unfavorable hemodynamic changes as propofol itself can induce hypotension. The aim of this study was to compare the effects of three different additional doses of propofol infusion on intubation conditions and hemodynamic changes occurred after intubation. This double-blinded prospective study was performed on 140 patients aged 18-60 who received different additional doses of propofol and were randomly allocated into 4 groups as follows: A: Received additional dose of propofol 0.5 mg/kg infused after an initial dose 1.5 mg/kg. B: Received additional dose of propofol 1 mg/kg infused after an initial dose 1 mg/kg. C: Received additional dose of propofol 1.5 mg/kg after an initial dose 1 mg/kg. D: Received propofol 2 mg/kg as a bolus with no additional dose. Intubation conditions were acceptable in 91.4% of Group A patients, 94.2% of Group B patients, 97.1% of Group C patients and 68.5% of Group D patients. There were no significant d...
ANAESTHESIA, PAIN & INTENSIVE CARE CONTENTS MARCH 2018 ISSUE
Technology and the future of anesthesiology 01 Amer Majeed How could fundamental disagreements 05 about the correct anatomy of the pediatric larynx develop during the last 15 years? Josef Holzki ORIGINAL ARTICLES A combination of intrarectal lignocaine 08 cream plus periprostatic nerve block improves pain control in transrectal ultrasound guided prostate biopsy: A prospective evaluation Ekrem Akdeniz, Sevda Akdeniz Evaluation of clinical effectiveness of three 16 different sedation protocols (intravenous propofol vs. ketamine vs. ketofol) in anxious children Gözde Yalçın, Nurhan Öztaş,Gülay Kip Effect of low dose intrathecal clonidine as an 26 adjuvant to hyperbaric bupivacaine on postoperative analgesia in patients undergoing elective infra umbilical surgeries Prachi Surve, Neeta Dsouza, Rajendra Patil, Dheeraj Narayan Agrawal, Anshumali Study to evaluate transversus abdominis 32 plane (TAP) block with ropivacaine in appendectomy patients by total requirement of diclofenac as a postoperative analgesia drug Intravenous regional anesthesia: comparing 48 efficacy of magnesium sulphate and clonidine as an adjuvant to lignocaine for intraoperative and postoperative analgesia. Deepak Solanki, Meena Singh Effectiveness of audio visual distraction using 55 virtual reality eyeglasses versus tablet device in child behavioral management during inferior alveolar nerve block A prospective randomized controlled trial 62 comparing the effects of dexmedetomidine and fentanyl on attenuation of pressor response during laryngoscopy and intubation Baikady Vasudevarao Sunil, Neeta Santha Comparison of postoperative pain relief 67 following use of spinal anesthesia versus general anesthesia for patients undergoing laparoscopic cholecystectomy Amna Sharaf, Ahmed Mujadid Burki, Saira Mahboob, Razia Bano Awareness, knowledge and attitude about 73 labor analgesia among providers and parturients; a survey based study Effectiveness of algorithm based teaching 81 on recognition and management of periarrest bradyarrhythmias among interns -a randomized control study Kusha Nag, Rani P. VR. Hemanth Kumar, Anand Monickam, Dewan Roshan Singh, T. Sivashanmugam Ultrasound guided 4 in 1 block -a newer, 87 single injection technique for complete postoperative analgesia for knee and below knee surgeries A comparison between intrathecal isobaric 94 levobupivacaine 0.5% and isobaric ropivacaine 0.5% in lower limb surgeries: a prospective, randomized, double blind study Kajal A. Bhatt, Ila A. Prajapati REVIEW ARTICLE Common low back pain, is it really a mystery? 125 Kjetil Larsen EDUCATION Fundamentals of clinical research 131 2: Designing a research study
2020
BackgroundThe severity of postoperative pain varies widely in the different types of anesthesia. The aim of the present study was to compare the effect of isoflurane-nitrous oxide anesthesia and propofol-remifentanil anesthesia on postoperative pain after foot and ankle surgery.MethodsIn this double-blind clinical trial, 60 eligible patients were divided into two equal intervention and control groups; the first group inhaled anesthesia with isoflurane-nitrous oxide and the control group were given intravenous anesthesia with propofol-remifentanil using the quadruple random block model and postoperative pain intensity was measured and compared in the two groups. Data on pain severity were collected at different times and analyzed using SPSS statistical software and related tests. The significant level was set at 0.05.ResultsOf the 60 participants, 38 (52.4%) were male and 22 (47.6%) were female. The mean age of the participants was 33.9±15.1 years. The intensity of pain in the recove...
2019
Background The aim of this study was to compare tracheal intubation conditions after anesthetic induction bolus of propofol-sufentanil or propofol-remifentanil. Methods A total of 70 patients, ASA I-II undergoing ambulatory surgery under general anesthesia with intubation for tooth extraction were randomly assigned in this double-blind study. They received either remifentanil (3 μg/kg) or sufentanil (0,3 μg/kg) associated with 2,5 mg/kg of propofol for intubation. Intubating conditions score were compared using the Scandinavian scale. The primary outcome was the comparison of the percentage of excellent intubation conditions. The secondary outcomes were the percentage of patients with a decrease of over 20% in MAP or HR, time to have a spontaneous respiration, time between the end of the surgery and extubation, time to obtain an Aldrete score of 10. The percentage of patients having a pain score>3 or having laryngeal pain 15 minutes after arriving in PACU were also analyzed. Disc...