The analgesic effects of intraoperative total intravenous anesthesia (TIVA) with propofol versus sevoflurane after colorectal surgery

Medicine (Baltimore). 2018 Aug;97(31):e11615. doi: 10.1097/MD.0000000000011615.

Abstract

Clinical studies have shown that total intravenous anesthesia (TIVA) with propofol is associated with better postoperative pain control compared with inhalational anesthesia, while other studies have not shown any benefit. The analgesic effect of TIVA with propofol in colorectal surgery has not been studied. The aim of this study is to evaluate the postoperative analgesic effects of TIVA with propofol versus inhalational sevoflurane in colorectal surgery.This is a retrospective case-control study. Records of patients undergoing colorectal surgery from 2014 to 2016 (36 months) were retrieved. Ninety-five patients who received TIVA with propofol were matched against 95 patients who received inhalational sevoflurane. Acute postoperative numerical rating scale (NRS) pain scores, postoperative morphine consumption, patient satisfaction, and side effects were compared and analyzed for differences between TIVA with propofol and sevoflurane.There were no significant differences in NRS pain scores, incidence of side effects, and patient satisfaction between the 2 groups. Patients receiving TIVA with propofol had significantly reduced total morphine consumption (P < .001), and daily morphine consumption on postoperative days 1 (P = .031), 2 (P = .002), and 3 (P = .031) compared with those receiving sevoflurane.TIVA with propofol was not associated with improved postoperative analgesia, better patient satisfaction, or reduced side effects. It may reduce postoperative opioid consumption after colorectal surgery.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Anesthesia / methods*
  • Anesthetics, Inhalation / administration & dosage*
  • Anesthetics, Intravenous / administration & dosage*
  • Case-Control Studies
  • Colon / surgery
  • Digestive System Surgical Procedures / adverse effects
  • Digestive System Surgical Procedures / methods
  • Female
  • Humans
  • Intraoperative Care / methods*
  • Male
  • Methyl Ethers / administration & dosage*
  • Middle Aged
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / etiology
  • Propofol / administration & dosage*
  • Rectum / surgery
  • Retrospective Studies
  • Sevoflurane
  • Treatment Outcome

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Methyl Ethers
  • Sevoflurane
  • Propofol