| Purpose: Reasonable pain management is closely related to the prognosis of patients.In this study, we sought to evaluate the effects of total intravenous anesthesia with propofol and inhalation anesthesia with sevoflurane on postoperative pain outcomes in patients undergoing radical gastrectomy in order to optimize postoperative pain management.Methods: Sixty ASA I or II patients aged 18-80 undergoing radical gastrectomy were randomly assigned to 2 equal groups, there were 30 patients in each group.General anesthesia in group propofol(Prop) and group sevoflurane(Sevo) was maintained with propofol intravenous target controlled infusion(TCI) after intravenous induction and tracheal intubation, titrated to maintain Bispectral Index values between 40 and 60.Visual analogue score(VAS) at rest and after cough were collected immediately after extubation, out of PACU, and at 4,12,24,and 48 h postoperatively, cumulative fentanyl consumption were recorded 4,24 and 48 h after surgery and postoperative chronic pain in one month and six months after discharge,were also recorded.Results: Sixty patients were included in the analyses.Demographic data and surgical characteristics were similar between the groups. At the time point at extubation, the propofol group had slower heart rates than the sevoflurane group(P = 0.043). Propofol reduces the VAS scores at rest and with coughing at extubation, out of PACU, and 4, 12, 24 and 48 h on the ward(P < 0.05) and cumulative fentanyl consumption 24 h after surgery( 364.4 ± 139.1 vs. 529.3 ± 237.9 μg, P = 0.002). The rescue analgesic requirements and the incidence of chronic pain 1 and 3 m after hospital discharge were not different between the two groups(P>0.05).Conclusions: In conclusion, this study demonstrated that maintenance of general anesthesia by propofol has the potential to reduce postoperative pain and needs less postoperative analgesic requirements compared with sevoflurane. |
PDF Full Text Request