Improved postoperative analgesia with isoflurane than with propofol anaesthesia.

Abstract

PURPOSE:

The impact of hypnotic drugs on postoperative analgesia has not been evaluated. We compared the influence of the maintenance of anaesthesia with either propofol or isoflurane on postoperative pain.

METHODS:

Forty ASA 1-2 women, undergoing cosmetic abdominoplasty were randomized to receive either 6-12 mg.kg-1.hr-1 propofol i.v. (P, n = 20) or MAC 1-1.5 isoflurane inhalation (Iso, n = 20). The lungs were ventilated with N2O 60% and O2 40%, and 1 microgram.kg-1 fentanyl i.v. provided intraoperative analgesia. Before surgical closure, 2 g propacetamol i.v. were administered. Postoperative analgesia was provided after hourly assessment of pain (VAS 0-100 mm), with 10 mg nalbuphine i.v. if VAS > or = 50 mm, during the eight hours after surgery. Sedation score (awake 0 to unrousable 4) was also recorded. Analgesia satisfaction score (nil 0 to excellent 4) obtained from the patient on discharge.

RESULTS:

Sedation scores were similar in both groups except in the first postoperative hour, when it was higher in the Iso group. The VAS at rest (15.4 +/- 18.6 vs 29.7 +/- 19.8 mm, P = 0.0001) and nalbuphine requirements (0.13 +/- 0.35 vs 0.70 +/- 0.80 doses, P = 0.004) were lower in the Iso group during the first six hours, although emesis was more frequent than in P (60 vs 25%; P = 0.03). The incidence of analgesia satisfaction score (> or = 3) was similar between the two groups (P: 95; Iso: 75%).

CONCLUSION:

These results suggested that isoflurane anaesthesia provides better analgesia than propofol anaesthesia in the first six hours after abdominoplasty.

• Authors: G Boccara, C Mann, Y Pouzeratte, A Bellavoir, A Rouvier, P Colson
• Journal: Canadian journal of anaesthesia = Journal canadien d'anesthesie (Can J Anaesth) Vol. 45 Issue 9 Pg. 839-42 (Sep 1998) ISSN: 0832-610X [Print] United States
• PMID: 9818105 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics
• Analgesics, Opioid
• Anesthetics, Inhalation
• Anesthetics, Intravenous
• Acetaminophen
• propacetamol
• Isoflurane
• Nalbuphine
• Fentanyl
• Propofol

Topics

• Abdomen (surgery)
• Acetaminophen (administration & dosage, analogs & derivatives, therapeutic use)
• Adult
• Analgesia
• Analgesics (administration & dosage, therapeutic use)
• Analgesics, Opioid (administration & dosage, therapeutic use)
• Anesthetics, Inhalation (administration & dosage, adverse effects)
• Anesthetics, Intravenous (administration & dosage, adverse effects)
• Female
• Fentanyl (administration & dosage, therapeutic use)
• Humans
• Injections, Intravenous
• Intraoperative Care
• Isoflurane (administration & dosage, adverse effects)
• Nalbuphine (administration & dosage, therapeutic use)
• Pain Measurement
• Pain, Postoperative (prevention & control)
• Patient Satisfaction
• Propofol (administration & dosage, adverse effects)
• Vomiting (chemically induced)