Randomized controlled trial of the effect of general anesthetics on postoperative recovery after minimally invasive nephrectomy

Yoon, Hyun Kyu; Joo, Somin; Yoon, Seung Zhoo; Seo, Jeonghwa; Lee, Ho-Jin

doi:10.4097/kja.23083

Cited by 3 publications

(4 citation statements)

References 39 publications

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“…Yoon et al explored the effects of propofol-based TIVA and desflurane anesthesia in laparoscopic nephrectomy. The TIVA group had a better QoR-15 score than the desflurane group on the first and second days but not on the third postoperative day [52].…”

Section: Discussionmentioning

confidence: 78%

The Effect of Epidural Analgesia on Quality of Recovery (QoR) after Open Radical Nephrectomy: Randomized, Prospective, and Controlled Trial

Kovač,

Juginović,

Delić

et al. 2024

JPM

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No studies are currently evaluating the quality of recovery (QoR) after open radical nephrectomy (ORN) and epidural morphine analgesia. This was a randomized, prospective, and controlled study that explored the QoR on the first postoperative day after ORN. Eighty subjects were randomized into two groups. The first group received general anesthesia combined with epidural anesthesia and postoperative epidural analgesia with morphine and ropivacaine. The second group received general anesthesia and continuous postoperative intravenous analgesia with tramadol. Both groups received multimodal analgesia with metamizole. The primary outcome measure was the total QoR-40 score. The secondary outcome measures were QoR-15, QoR-VAS, and the visual analog scale (VAS) for pain, anxiety, and nausea. The median difference in the QoR-40 score after 24 postoperative hours between the two groups of patients was 10 (95% CI: 15 to 5), p < 0.0001. The median score and IQR of QoR-40 during the first 24 postoperative hours in the epidural group was 180 (9.5), and in the control group, it was 170 (13). The general independence test for secondary outcomes between groups was significant (p < 0.01). QoR-VAS was correlated with QoR-40 (r = 0.63, p ≤ 0.001) and with QoR-15 (r = 0.54, p ≤ 0.001). The total QoR-40 and QoR-15 alpha coefficients with a 95% CI were 0.88 (0.85–0.92) and 0.73 (0.64–0.81), respectively. There was a significant difference in the QoR between the epidural and the control groups after ORN. The QoR-40 and QoR-15 showed good convergent validity and reliability.

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Section: Discussionmentioning

confidence: 78%

The Effect of Epidural Analgesia on Quality of Recovery (QoR) after Open Radical Nephrectomy: Randomized, Prospective, and Controlled Trial

Kovač,

Juginović,

Delić

et al. 2024

JPM

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“…The perioperative management protocol we applied might have influenced these results. In both groups, propofol-based total intravenous anesthesia was administered, which may have reduced the postoperative opioid requirements [ 26 ], thereby diminishing the apparent magnitude of the opioid-sparing effect of the acetaminophen/ibuprofen combination. Additionally, the administration of dexamethasone and the implementation of preemptive intercostal nerve blockade in both groups likely influenced this outcome [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of an intravenous acetaminophen/ibuprofen fixed-dose combination on postoperative opioid consumption and pain after video-assisted thoracic surgery: a double-blind randomized controlled trial

Lee,

Choi,

Yoon

et al. 2024

Surg Endosc

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Background Video-assisted thoracoscopic surgery (VATS) often induces significant postoperative pain, potentially leading to chronic pain and decreased quality of life. This study aimed to evaluate the acetaminophen/ibuprofen combination effectiveness in reducing analgesic requirements and pain intensity in patients undergoing VATS. Study design This is a double-blinded randomized controlled trial. Methods Adult patients scheduled for elective VATS for lung resection were randomized to receive either intravenous acetaminophen and ibuprofen (intervention group) or 100 mL normal saline (control group). Treatments were administered post-anesthesia induction and every 6 h for three cycles. The primary outcome was total analgesic consumption at 24 h postoperatively. Secondary outcomes were cumulative analgesic consumption at 2 and 48 h; analgesic-related side effects at 2, 24, and 48 h; quality of recovery at 24 h and 48 h postoperatively; pain intensity at rest and during coughing; and rescue analgesics use. Chronic postsurgical pain (CPSP) was assessed through telephone interviews 3 months postoperatively. Results The study included 96 participants. The intervention group showed significantly lower analgesic consumption at 24 h and 48 h postoperatively (24 h: median difference: − 100 µg equivalent intravenous fentanyl [95% confidence interval (CI) − 200 to − 5 μg], P = 0.037; 48 h: median difference: − 140 μg [95% CI − 320 to − 20 μg], P = 0.035). Compared to the controls, the intervention group exhibited a significantly lower quality of recovery 24 h post-surgery, with no significant difference at 48 h. All pain scores except for coughing at 48 h post-surgery were significantly lower in the intervention group compared to the controls. No significant differences were observed between the groups in postoperative nausea and vomiting occurrence, hospital stay length, and CPSP. Conclusion Perioperative administration of acetaminophen/ibuprofen significantly decreased analgesic needs in patients undergoing VATS, providing an effective postoperative pain management strategy, and potentially minimizing the need for stronger analgesics.

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“…Changes in the QoR-15 score over time after surgery may provide more valuable information on postoperative recovery. 28 Lastly, we have not investigated the quality of postoperative recovery after discharge. The association between acute and chronic postoperative pain is well known, 33 but so far, the impact of acute postoperative pain on the overall quality of postoperative recovery after discharge has not been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, recently, several studies that used quality of postoperative recovery, rather than pain intensity, as the primary outcome have been reported. [22][23][24][25][26][27][28] As the importance of using patient-reported outcome assessments such as the QoR-15 questionnaire in surgical patients is emphasized, 29,30 the number of clinical studies on postoperative pain using the QoR-15 score as the primary endpoint is increasing. 31 Postoperative recovery evaluated using the QoR questionnaire can provide more meaningful clinical information than that obtained using pain intensity scoring.…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Pain Intensity and Quality of Recovery After Video-Assisted Thoracic Surgery for Lung Cancer Resection

Yoon,

Bae,

Yoon

et al. 2023

JPR

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Purpose The Quality of Recovery-15 (QoR-15) questionnaire provides a multifaceted assessment of postoperative recovery, and the resulting score is recommended as an endpoint in clinical studies focused on postoperative pain. We aimed to investigate the correlation between the QoR-15 score and postoperative pain intensity in surgical patients. Patients and Methods Adult patients who underwent video-assisted thoracoscopic surgery (VATS) for lung cancer resection and were enrolled in a prospective registry or in a previous prospective study were included in this study. Baseline and perioperative data, including the results of assessment using the Korean version of the QoR-15 (QoR-15K) questionnaire at 48 hours postoperatively, were collected from the database. Correlations between the QoR-15K total score, questionnaire dimensions, and postoperative pain intensity at 48 hours postoperatively were determined using the Spearman correlation coefficient ( ρ ). Results We analyzed a total of 137 eligible patients. Significant negative correlations were noted between the QoR-15K total score and pain intensity at rest ( ρ = −0.45, 95% confidence interval [CI]: −0.57 − −0.31, P < 0.001) and during coughing ( ρ = −0.55, 95% CI: −0.65 − −0.42, P < 0.001) at 48 hours postoperatively. The pain dimension and pain intensity at 48 hours postoperatively showed significant correlations with physical comfort, emotional state, and physical independence dimensions. Multivariable logistic regression revealed a significant negative association between the pain score at 24 hours postoperatively and good or excellent postoperative recovery. Conclusion The results support the impact of postoperative pain on the overall postoperative quality of recovery in patients who underwent VATS for lung cancer resection. Moreover, the QoR-15K score may be considered as a primary endpoint in clinical studies on postoperative pain control.

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Randomized controlled trial of the effect of general anesthetics on postoperative recovery after minimally invasive nephrectomy

Cited by 3 publications

References 39 publications

The Effect of Epidural Analgesia on Quality of Recovery (QoR) after Open Radical Nephrectomy: Randomized, Prospective, and Controlled Trial

The Effect of Epidural Analgesia on Quality of Recovery (QoR) after Open Radical Nephrectomy: Randomized, Prospective, and Controlled Trial

Effect of an intravenous acetaminophen/ibuprofen fixed-dose combination on postoperative opioid consumption and pain after video-assisted thoracic surgery: a double-blind randomized controlled trial

Correlation Between Pain Intensity and Quality of Recovery After Video-Assisted Thoracic Surgery for Lung Cancer Resection

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