Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
Acta Anaesthesiol Scand. 2012 Mar;56(3):368-75. doi: 10.1111/j.1399-6576.2011.02603.x. Epub 2011 Dec 23.
There is some evidence that propofol may reduce post-operative pain. However, the results on the analgesic effects of propofol are inconsistent. Thus, we hypothesized that propofol reduces acute pain if confounding factors like opioids are avoided.
In this prospective, randomized, subject- and assessor-blind, parallel-group, head-to-head comparative study, 90 American Society of Anesthesiologists I or II females underwent elective laparoscopies were randomized to receive either propofol-based (PR), or sevoflurane-based (SR), or sevoflurane-propofol-based anesthesia (SPR). Pain score at rest assessed by a numerical rating scale at 0.5 h after surgery was the primary outcome. The secondary outcomes included pain score at 1 and 24 h post-operatively, duration of post-anesthesia care units stay (PACU), incidence of post-operative nausea and vomiting, incidence of shivering, and post-operative quality of recovery score (QoR-40) within the first 24 h post-operatively.
No patients received rescue analgesia. The pain score at 0.5 h post-operatively was less in group PR when compared with group SR (0.7 ± 1.4 vs. 2.1 ± 1.8; P = 0.010) or group SPR (0.7 ± 1.4 vs. 2.1 ± 2.2; P = 0.008). Group PR was also associated with shorter PACU stay than group SR (21.8 ± 5.7 vs. 26.2 ± 6.9; P = 0.050) or group SPR (21.8 ± 5.7 vs. 27.8 ± 8.9; P = 0.005). Intraoperative bispectral index values, hemodynamic values and post-operative QoR-40 scores did not differ among the three groups.
Propofol anesthesia was associated with significantly less pain at 0.5 and 1 h after surgery in patients undergoing gynecological laparoscopies with planned opioid-free post-operative analgesia.
有一些证据表明丙泊酚可能会减轻术后疼痛。然而，关于丙泊酚的镇痛效果的结果并不一致。因此，我们假设如果避免使用阿片类药物等混杂因素，丙泊酚会减轻急性疼痛。
在这项前瞻性、随机、患者和评估者盲法、平行组、头对头比较研究中，90 名美国麻醉医师学会（ASA）分级 I 或 II 级女性接受择期腹腔镜手术，随机分为丙泊酚组（PR）、七氟醚组（SR）或七氟醚-丙泊酚组（SPR）。术后 0.5 小时通过数字评分量表评估静息时的疼痛评分，这是主要结局。次要结局包括术后 1 小时和 24 小时的疼痛评分、麻醉后监护室（PACU）停留时间、术后恶心和呕吐发生率、寒战发生率以及术后 24 小时内的恢复质量评分（QoR-40）。
没有患者接受补救性镇痛。与 SR 组（0.7±1.4 比 2.1±1.8；P=0.010）或 SPR 组（0.7±1.4 比 2.1±2.2；P=0.008）相比，PR 组术后 0.5 小时的疼痛评分较低。与 SR 组（21.8±5.7 比 26.2±6.9；P=0.050）或 SPR 组（21.8±5.7 比 27.8±8.9；P=0.005）相比，PR 组 PACU 停留时间也较短。三组之间的术中脑电双频指数值、血流动力学值和术后 QoR-40 评分无差异。
在计划无阿片类药物术后镇痛的妇科腹腔镜手术患者中，丙泊酚麻醉与术后 0.5 小时和 1 小时的疼痛明显减轻相关。
