M. Ogurlu, S. Sari, M. Küçük, M. Bakis, B. Ugur, YE. Eshraghi, F.
Galimberti, A. Turan
Anaesthesia and Intensive Care
Volume 42, Issue 3 May 2014
This study was designed to evaluate the hypothesis that propofol reduces acute
and chronic postoperative pain compared with sevoflurane. In a randomised,
prospective, double-blind trial, we assigned 80 patients having open total
abdominal hysterectomy surgery to anaesthesia with either sevoflurane or
propofol. Anaesthesia was titrated to clinical needs and bispectral index values
to between 40 and 60. Postoperative pain was managed with pethidine and
diclofenac. Acute postoperative pain for 24 hours and chronic postoperative pain
at one and three months after surgery were evaluated. The Hospital Anxiety and
Depression Scale was used to evaluate patient anxiety and depression after one
and three months. There were no significant differences between the groups for
opioid consumption or opioid-induced side-effects. Pain scores in the first four
hours were significantly higher in the sevoflurane group. Persistent surgical
pain was observed less frequently (7 out of 40 patients in the propofol group
and 21 out of 40 in the sevoflurane group at three months post-surgery, P
<0.01) and pain scores were lower at one and three months in the propofol
group (0.78±0.55 versus 2.23±0.73 for the sevoflurane group at three months
post-surgery, P <0.01). Anxiety and depression scores were
significantly lower in the propofol group at three months. In this study,
general anaesthesia with propofol was associated with reduced early acute
postoperative and persistent pain, compared to sevoflurane-based anaesthesia,
among patients undergoing open abdominal hysterectomy.
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