Abstract
BackgroundPatients receiving total intravenous anesthesia (TIVA) with propofol have been shown to experience less postoperative pain. We evaluated the post-operative analgesic effects of propofol compared with sevoflurane maintenance of anesthesia in liver surgery. This study was registered at ClinicalTrials.gov (NCT02179437).MethodsIn this retrospective study, records of patients who underwent liver surgery between 2010 and 2013 were reviewed. Ninety-five patients anesthetized with propofol TIVA were matched with 95 patients anesthetized with sevoflurane. Numeric pain rating scale (NRS) pain scores, postoperative morphine consumption, side effects and patients’ satisfaction with pain relief were evaluated.ResultsThe TIVA group reported lower NRS pain scores during coughing on postoperative days 1 and 2 but not 3 (p = 0.0127, p = 0.0472, p = 0.4556 respectively). They also consumed significantly less daily (p = 0.001 on day 1, p = 0.0231 on day 2, p = 0.0004 on day 3), accumulative (p = 0.001 on day 1, p<0.0001 on day 2 and p = 0.0064 on day 3) and total morphine (p = 0.03) when compared with the sevoflurane group. There were no differences in total duration of intravenous patient controlled analgesia (PCA) morphine use and patient satisfaction. No difference was found in reported side effects.ConclusionPatients anesthetized with propofol TIVA reported less pain during coughing and consumed less daily, accumulative and total morphine after liver surgery.
Highlights
Postoperative pain can be severe after liver surgery due to the upper abdominal incision and pain management can be difficult for this group of patients [1]
Patients anesthetized with propofol total intravenous anesthesia (TIVA) reported less pain during coughing and consumed less daily, accumulative and total morphine after liver surgery
Data collected included demographic data (age, body weight, gender and American Society of Anesthesiologists (ASA) physical status); types of liver surgery performed; types of general anesthesia techniques; with or without intraoperative use of ketamine; pain intensity as verbal numerical rating scale (NRS, 0 = no pain, 10 = the worst imaginable pain) at rest and during coughing from postoperative days 1 to 3; daily, accumulative and total postoperative morphine consumption and duration of patient-controlled analgesia (PCA) use; incidence of adverse events and patients’ satisfaction with pain relief
Summary
Patients receiving total intravenous anesthesia (TIVA) with propofol have been shown to experience less postoperative pain.
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