Abstract
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.
Highlights
Propofol is an intravenous hypnotic that is commonly used in total intravenous anesthesia (TIVA) because of its widely acknowledged antiemetic properties
A secondary goal of this work was to compare the quality of recovery between patients anesthetized using TIVA to patients anesthetized using inhalational anesthesia by evaluating post-operative nausea and vomiting (PONV), pain, administration of narcotics, and time to recovery
We hypothesized that patients anesthetized with TIVA using propofol would have less pain, PONV, and a faster recovery time post-operatively than those anesthetized with sevoflurane
Summary
Propofol is an intravenous hypnotic that is commonly used in total intravenous anesthesia (TIVA) because of its widely acknowledged antiemetic properties. It may be the better choice for induction and maintenance of anesthesia in patients due to a reported analgesic effect [1,2] that, combined with its antiemetic properties, provide patients with a better quality of recovery. A secondary goal of this work was to compare the quality of recovery between patients anesthetized using TIVA (propofol/remifentanil) to patients anesthetized using inhalational anesthesia (sevoflurane/remifentanil) by evaluating post-operative nausea and vomiting (PONV), pain, administration of narcotics, and time to recovery. 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
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