Department of Anesthesiology and Reanimation, University Clinical Centre of Kosova, Prishtina, Kosovo.
Pain Med. 2013 Mar;14(3):442-6. doi: 10.1111/pme.12031. Epub 2013 Jan 7.
Postoperative analgesia remains a problem, especially in pediatric patients. We hypothesize that patients anesthetized with sevoflurane have more postoperative pain than with propofol.
Randomized, prospective, double-blind study.
University teaching hospital.
The subjects were 88 premedicated children, aged 3-6 years, and American Society of Anesthesiologists (ASA) Physical Status I or II.
Subjectsunderwent hernia repair surgery.
Anesthesia was maintained with propofol (group P, N = 46) or sevoflurane (group S, N = 42) and fentanyl was administered during surgery. All children before surgical incision received 40 mg/kg paracetamol, rectally. Prior to wound closure, the margins were infiltrated with 0.5% bupivacaine.
The primary outcome was pain score assessed by Faces Pain Scale (FPS) 2 hours postoperatively. The secondary outcomes included recovery time and adverse events within the first 2 hours.
Group S had a significantly higher proportion of patients who exhibited postoperative pain than group P (24.3% vs 4.5%, respectively; P < 0.05). FPS score in group P was 1.2 ± 0.6, compared with 3.4 ± 1.5 in group S (P < 0.001). Mean recovery time in group S was significantly shorter than the corresponding mean for group P (10.1 ± 1.3 vs 16.5 ± 5.4 minutes, respectively; P < 0.001).
In children, anesthesia maintenance with propofol was associated with a significantly lower incidence of postoperative pain than with sevoflurane.
术后镇痛仍然是一个问题，特别是在儿科患者中。我们假设接受七氟醚麻醉的患者比接受异丙酚麻醉的患者术后疼痛更明显。
随机、前瞻性、双盲研究。
大学教学医院。
88 名接受术前用药的 3-6 岁儿童，美国麻醉医师协会（ASA）身体状况 I 或 II 级。
所有患儿均行疝修补术。
异丙酚（P 组，N = 46）或七氟醚（S 组，N = 42）维持麻醉，术中给予芬太尼。所有患儿在手术切口前均接受 40mg/kg 对乙酰氨基酚直肠给药。在关闭切口前，边缘浸润 0.5%布比卡因。
术后 2 小时采用面部疼痛评分（FPS）评估主要结局，次要观察指标包括恢复时间和术后 2 小时内的不良事件。
S 组术后疼痛的患者比例明显高于 P 组（分别为 24.3%和 4.5%，P < 0.05）。P 组 FPS 评分为 1.2 ± 0.6，S 组为 3.4 ± 1.5（P < 0.001）。S 组的平均恢复时间明显短于 P 组（分别为 10.1 ± 1.3 分钟和 16.5 ± 5.4 分钟，P < 0.001）。
在儿童中，与七氟醚相比，异丙酚维持麻醉与术后疼痛发生率显著降低相关。
