Effects of different anesthetic methods on postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy

Abstract

Objective To evaluate the effects of different anesthetic methods on postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy. Methods Fifty-four patients of both sexes, aged 18-64 yr, with body mass index of 20-28 kg/m2, of American Society of Anesthesiologists physical statusⅠor Ⅱ, scheduled for elective video-assisted thoracoscopic thymectomy, were allocated into 2 groups (n=27 each) using a random number table method: sevoflurane-based anesthesia group (group S) and propofol-based anesthesia group (group P). After routine anesthesia induction in two groups, anesthesia was maintained by inhaling sevoflurane and target-controlled infusion of remifentanil in group S and by target-controlled infusion of propofol and remifentanil in group P. Heart rate and mean arterial pressure were recorded before operation and at 5 and 10 min after extubation (T1, 2). The intensity of pain at T2 and visual analog scale (VAS) score and consumption of morphine at 1, 2, 4, 24 and 48 h after operation (T3-7) were recorded.The pressing times of analgesia pump, requirement for rescue analgesia and development of nausea and vomiting were recorded at T7. Results There were no significant differences in heart rate or mean arterial pressure at each time point between two groups (P>0.05). Compared with group S, the intensity of pain was significantly alleviated at T2, and VAS scores and morphine consumption were decreased at T3, 4 in group P (P 0.05). Conclusion Propofol-based anesthesia provides better efficacy in alleviating postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy. Key words: Propofol; Anesthetics, inhalation; Pain postoperative; Myasthenia gravis; Thoracoscopy; Thymectomy