Abstract PR627

Abstract

Background & Objectives: The use of total intravenous anesthesia (TIVA) has been shown to improve recovery and lower postoperative pain scores in a number of different types of surgery. In this study we aim to examine the effects of TIVA on the postoperative pain scores after pancreatic cancer surgery. Materials & Methods: After IRB approval, a retrospective review of adult patients undergoing pancreatic cancer surgery between November 2011 and August 2014 was performed. Patients receiving premedication with celecoxib, pregabalin, and tramadol, followed by intraoperative infusions of propofol, lidocaine, dexmedetomidine, and ketamine without intravenous opioids were classified under the TIVA-group. Patients receiving volatile anesthetics with intravenous opioids were grouped under the volatile-opioid group (VO-group). Patient demographics, intraoperative variables, postoperative opioid use, and postoperative pain scores (POD0, POD1, POD2) were analyzed. Results: Patients who received TIVA had statistically lower postoperative pain scores (Figure 1) on the day of surgery (P<0.0001), POD1 (P=0.0001), and POD2 (P=0.05), and lower MEDD IV (TIVA: 33.7±57.9 vs. VO: 57.4±242.6; P=0.02). There was no statistical difference in length of hospital stay between the study groups.Table 1:: Patient and Clinical Variables (VO-group vs. TIVA-group)Conclusion: In patients undergoing pancreatic cancer surgery, the use of TIVA was associated with lower early postoperative pain scores and less daily IV morphine use. The lower pain scores are likely related to the use of mutlimodal opioid sparring techniques. Limitations to this study include that patients were not matched according to surgery type. Despite longer and more extensive surgery, the TIVA group had lower early postoperative pain scores.