Department of Anesthesiology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China.
Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China.
Pain Pract. 2021 Jan;21(1):37-44. doi: 10.1111/papr.12931. Epub 2020 Aug 2.
Propofol and sevoflurane as frequently used general anesthetics can affect postoperative pain. Our study explored whether the incidence of postoperative pain differed among patients with chronic pain undergoing total knee arthroplasty (TKA) anesthetized with sevoflurane or propofol.
Patients were randomly assigned to groups receiving either sevoflurane (Group S, n = 50) or propofol (Group P, n = 47) for anesthesia maintenance during TKA. The incidences of postoperative pain and quality of life (QoL) were measured using the EuroQol 5-Dimension (EQ-5D) scale at 1, 3, and 7 days post-operation (DPO), and 1 and 3 months post-operation (MPO).
At 3 DPO, fewer patients reported moderate pain (P = 0.001) and more patients reported no pain (P = 0.003) in Group S than that in Group P. At 3 MPO, more patients reported no pain (P = 0.04) and fewer patients reported moderate pain (P = 0.04) in Group S than in Group P. No significant differences were found in the incidence of postoperative pain between the 2 groups of patients at the other time points. The EQ-5D scores were higher in Group S than in Group P (P = 0.022), and the difference was 0.15 at most, which was not optimal. The EQ-5D clinical results might be not very significant.
Sevoflurane anesthesia may have potential advantages in reducing postoperative pain in patients undergoing TKA with a preoperative VAS score > 4.
丙泊酚和七氟醚作为常用的全身麻醉药物，可影响术后疼痛。本研究旨在探讨术前视觉模拟评分（VAS）＞4 的行全膝关节置换术（TKA）的慢性疼痛患者，接受七氟醚或丙泊酚麻醉时术后疼痛的发生率是否不同。
患者随机分为七氟醚组（S 组，n=50）和丙泊酚组（P 组，n=47），两组均行 TKA 麻醉维持。采用欧洲五维健康量表（EQ-5D）在术后 1、3、7 天（DPO）和术后 1、3 个月（MPO）评估术后疼痛发生率和生活质量（QoL）。
术后 3 DPO，S 组报告中度疼痛的患者比例低于 P 组（P=0.001），报告无痛的患者比例高于 P 组（P=0.003）。术后 3 MPO，S 组报告无痛的患者比例高于 P 组（P=0.04），报告中度疼痛的患者比例低于 P 组（P=0.04）。两组患者在其他时间点的术后疼痛发生率均无显著差异。S 组的 EQ-5D 评分高于 P 组（P=0.022），且差值最高为 0.15，差异无统计学意义。EQ-5D 临床结果可能不是很显著。
对于术前 VAS 评分＞4 的行 TKA 的慢性疼痛患者，七氟醚麻醉可能具有减轻术后疼痛的潜在优势。
