The effects of propofol vs. sevoflurane on post-operative pain and need of opioid

Pokkinen, Satu M.; Yli‐Hankala, Arvi; Kalliomäki, Maija-Liisa

doi:10.1111/aas.12366

Cited by 34 publications

(40 citation statements)

References 25 publications

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“…A total of 13 trials reported pain intensity at or around 2 h postsurgery, in which 686 patients received anaesthesia using propofol for maintenance, while 668 were given inhalational anaesthesia [10,11,[18][19][20][21][22][23][24][25][26][27][28]. Overall, pain scores were not significantly different between experimental groups (Hedge's g (95%CI) À0.120 (À0.415-0.175) (p = 0.425) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…A total of nine trials reported pain intensity at or around 24 h postsurgery, in which 595 patients received propofol anaesthesia, while 586 had inhalational anaesthesia [10,11,18,19,21,22,25,28,29]. Overall, compared with inhalational anaesthetics, patients who received propofol reported significantly lower pain scores 24 h postsurgery (Hedge's g (95% CI) À0.134 (À0.248 to À0.021) (p = 0.021) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The first hint of a possible postoperative analgesic effect of propofol was a somewhat serendipitous discovery [9], but this finding has also been suggested by other clinical trials comparing inhalational anaesthetics [9,10], although results have been mixed [11]. A previous meta-analysis exploring the analgesic efficacy of propofol concluded that propofol might improve postoperative analgesia compared with other anaesthetics, including isoflurane and thiopentone, and that its use was associated with fewer adverse effects [12].…”

Section: Introductionmentioning

confidence: 91%

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Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

et al. 2016

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SummaryPropofol is used both for induction and maintenance of anaesthesia. Recent evidence shows that propofol has analgesic properties. This meta-analysis evaluated differences in postoperative analgesia between general anaesthetic maintenance with intravenous propofol and inhalational anaesthetics. Fourteen trials met inclusion criteria and were included. Our outcomes were pain scores 2 and 24 h after surgery. No significant difference in pain scores was found at 2 h after surgery (Hedge's g (95% CI) À0.120 (À0.415-0.175) (p = 0.425). Propofol was associated with a statistically significant, albeit marginal, reduction in pain scores 24 h after surgery (Hedge's g (95% CI) À0.134 (À0.248 to À0.021) (p = 0.021). Data were insufficient to allow a meaningful analysis regarding 24-h morphine-equivalent consumption. Propofol was associated with reduced postoperative nausea and vomiting (relative risk (95%CI) 0.446 (0.304-0.656) (p < 0.0001). In conclusion, this meta-analysis suggests that propofol improves postoperative analgesia compared with inhalational anaesthesia 24 h after surgery, with a lower incidence of nausea and vomiting.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

See 1 more Smart Citation

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

et al. 2016

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“…In a study comparing isoflurane and propofol for maintenance of general anesthesia, pain scores and postoperative analgesic requirements were comparable in the two groups,45 and in a similar study no difference was found when anesthesia was maintained with sevoflurane versus propofol 46. Finally, a single antiemetic dose of propofol at the end of surgery did not influence pain scores or opioid requirements 47…”

Section: Resultsmentioning

confidence: 89%

Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations

Lirk

Thiry

Bonnet

et al. 2019

Reg Anesth Pain Med

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Background and objectivesLaparoscopic hysterectomy is increasingly performed because it is associated with less postoperative pain and earlier recovery as compared with open abdominal hysterectomy. The aim of this systematic review was to evaluate the available literature regarding the management of pain after laparoscopic hysterectomy.Strategy and selection criteriaRandomized controlled trials evaluating postoperative pain after laparoscopic hysterectomy published between January 1996 and May 2018 were retrieved, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, from the EMBASE and MEDLINE databases and the Cochrane Register of Controlled Trials. Efficacy and adverse effects of analgesic techniques were assessed.ResultsOf the 281 studies initially identified, 56 were included. Of these, 31 assessed analgesic or anesthetic interventions and 25 assessed surgical interventions. Acetaminophen, non-steroidal anti-inflammatory drugs, and dexamethasone reduced opioid consumption. Limited evidence hindered recommendations on alpha-2-agonists. Inconsistent evidence was found in the studies investigating pregabalin and transversus abdominis plane block, and no evidence was found for intraperitoneal local anesthetics, port site infiltration, or single-port laparoscopy. Measures to lower peritoneal insufflation pressure or humidify or heat insufflated gas seem to reduce the incidence of shoulder pain, but not abdominal pain.ConclusionsThe baseline analgesic regimen for laparoscopic hysterectomy should include acetaminophen, a non-steroidal anti-inflammatory drug, dexamethasone, and opioids as rescue analgesics.

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“…For example, changes in pain perception are caused in many different ways by anesthetics such as thiopental, which can decrease the pain threshold caused by pressure stimulation and increase heat pain threshold 47. Despite it is the most widely used general anesthetic and exhibits analgesic properties, the clinical use of propofol has been debated 8910. It can decrease pain transmission in the rat spinal cord in vitro and in vivo studies and the subliminal dose of propofol has been reported to increase sensitivity to pain in many cases.…”

Section: Introductionmentioning

confidence: 99%

Effect of intravenous anesthesia with propofol versus isoflurane inhalation anesthesia in postoperative pain of inguinal herniotomy: a randomized clinical trial

et al. 2017

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Postoperative pain is a common problem after inguinal herniotomy. We aimed to compare the intravenous anesthesia effects of propofol and isoflurane inhalation anesthesia on postoperative pain after inguinal herniotomy. In a randomized clinical trial, 102 eligible patients were selected based on inclusion and exclusion criteria and were randomly divided in two groups. In the first group, propofol was used for the maintenance of anesthesia, while isoflurane was used in the second group. The patient’s heart rate, systolic and diastolic blood pressure and oxygen saturation before, during and after surgery, recovery time and postoperative pain were measured immediately, 2, 4 and 6 hours after surgery and compared between two groups. T-test, and repeated measurement test were used for statistical analysis. No statistically significant differences were observed in heart rate, blood pressure and oxygen saturation levels between the two groups (P > 0.05). Propofol has higher effect in easing postoperative pain of patients than isoflurane, but no difference in postoperative complications, including chills, nausea and vomiting, occurs in both two groups. Propofol is effective in declining the postoperative pain of patients after anesthesia in comparison with isoflurane. Moreover, due to the antioxidant, anti-inflammatory and analgesic properties of propofol, it is preferred to isoflurane and the authors recommended it to be used.

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The effects of propofol vs. sevoflurane on post-operative pain and need of opioid

Abstract: In this study, comparing sevoflurane with propofol for maintenance of general anaesthesia, the choice of anaesthetic had no effect on the requirement of oxycodone or intensity of pain after surgery.

Cited by 34 publications

References 25 publications

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations

Effect of intravenous anesthesia with propofol versus isoflurane inhalation anesthesia in postoperative pain of inguinal herniotomy: a randomized clinical trial

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