Department of Emergency medicine, Cheongyang Health Center County Hospital, Chungcheongnam-do, Republic of Korea.
Department of anesthesiology and Pain medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
BMC Anesthesiol. 2020 Oct 28;20(1):273. doi: 10.1186/s12871-020-01190-9.
Enhancing postoperative recovery of the donor is important to encourage living kidney donation. We investigated the effects of anesthetic agents (intravenous [IV] propofol versus inhaled [IH] sevoflurane) on the quality of early recovery of healthy living kidney donors after hand-assisted laparoscopic nephrectomy (HALN) under analgesic intrathecal morphine injection.
This single-center, prospective randomized controlled study enrolled 80 living donors undergoing HALN from October 2019 to June 2020 at Seoul St. Mary's Hospital. Donors were randomly assigned to the IV propofol group or IH sevoflurane group. To measure the quality of recovery, we used the Korean version of the Quality of Recovery-40 questionnaire (QoR-40 K) on postoperative day (POD) 1, and ambulation (success rate, number of footsteps) 6-12 h after surgery and on POD 1. The pain score for the wound site, IV opioid requirement, postoperative complications including incidences of nausea/vomiting, and length of in-hospital stay were also assessed.
The global QoR-40 K score and all subscale scores (physical comfort, emotional state, physical independence, psychological support, and pain) were significantly higher in the IV propofol group than in the IH sevoflurane group. The numbers of footsteps at all time points were also higher in the IV propofol group. Donors in the IV propofol group had a lower incidence of nausea/vomiting, and a shorter hospitalization period.
Total IV anesthesia with propofol led to better early postoperative recovery than that associated with IH sevoflurane.
Clinical Research Information Service, Republic of Korea (approval number: KCT0004351 ) on October 18, 2019.
促进供体术后恢复对于鼓励活体肾脏捐献非常重要。我们研究了在鞘内注射吗啡镇痛下，手辅助腹腔镜肾切除术（HALN）后，静脉内（IV）异丙酚与吸入（IH）七氟醚两种麻醉剂对健康活体肾脏供者早期恢复质量的影响。
这项单中心前瞻性随机对照研究于 2019 年 10 月至 2020 年 6 月在首尔圣玛丽医院纳入 80 例接受 HALN 的活体供者。供者随机分配至 IV 异丙酚组或 IH 七氟醚组。为了衡量恢复质量，我们在术后第 1 天（POD）和术后 6-12 小时以及 POD1 使用韩国版恢复质量 40 问卷（QoR-40K）进行测量。还评估了伤口部位疼痛评分、IV 阿片类药物需求、术后并发症（包括恶心/呕吐发生率）以及住院时间。
IV 异丙酚组的总体 QoR-40K 评分和所有子量表评分（身体舒适度、情绪状态、身体独立性、心理支持和疼痛）均显著高于 IH 七氟醚组。IV 异丙酚组在所有时间点的步数也更高。IV 异丙酚组恶心/呕吐发生率较低，住院时间较短。
与 IH 七氟醚相比，全身 IV 麻醉异丙酚可导致更好的早期术后恢复。
2019 年 10 月 18 日，韩国临床试验注册（注册号：KCT0004351）。
