Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Effects of propofol-remifentanil versus sevoflurane-remifentanil on acute postoperative pain after total shoulder arthroplasty: a randomized trial

  • Eun Kyung Choi (Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine) ;
  • Saeyoung Kim (Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University) ;
  • Do young Kim (Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine)
  • Received : 2022.02.15
  • Accepted : 2022.02.27
  • Published : 2023.07.31
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Abstract

Background: While some evidence indicates that propofol-based anesthesia has less postoperative pain than sevoflurane-based anesthesia, these results are controversial. We compared acute postoperative pain intensity and opioid consumption after total shoulder arthroplasty between propofol-remifentanil (PR) and sevoflurane-remifentanil (SR) anesthesia. Methods: Among 48 patients undergoing shoulder arthroscopic surgery anesthetized with PR or SR, postoperative pain intensity was assessed at 30 minutes and at 2, 6, 12, and 24 hours. The total patient-controlled analgesia volume and number of patients requiring rescue analgesics were assessed. Results: No significant difference in postoperative pain intensity was observed between the two groups. Postoperative opioid consumption and analgesic requirements were also comparable in the first 24 hours after surgery. Conclusion: PR and SR anesthesia for shoulder arthroscopic surgery provide comparable postoperative analgesia results.

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References

  1. Wu CL, Raja SN. Treatment of acute postoperative pain. Lancet 2011;377:2215-25. https://doi.org/10.1016/S0140-6736(11)60245-6
  2. Cheng SS, Yeh J, Flood P. Anesthesia matters: patients anesthetized with propofol have less postoperative pain than those anesthetized with isoflurane. Anesth Analg 2008;106:264-9. https://doi.org/10.1213/01.ane.0000287653.77372.d9
  3. Li M, Mei W, Wang P, Yu Y, Qian W, Zhang ZG, et al. Propofol reduces early post-operative pain after gynecological laparoscopy. Acta Anaesthesiol Scand 2012;56:368-75. https://doi.org/10.1111/j.1399-6576.2011.02603.x
  4. Fassoulaki A, Melemeni A, Paraskeva A, Siafaka I, Sarantopoulos C. Postoperative pain and analgesic requirements after anesthesia with sevoflurane, desflurane or propofol. Anesth Analg 2008;107:1715-9. https://doi.org/10.1213/ane.0b013e318182d84e
  5. Pokkinen SM, Yli-Hankala A, Kalliomaki ML. The effects of propofol vs. sevoflurane on post-operative pain and need of opioid. Acta Anaesthesiol Scand 2014;58:980-5. https://doi.org/10.1111/aas.12366
  6. Shin S, Min KT, Shin YS, Joo HM, Yoo YC. Finding the 'ideal' regimen for fentanyl-based intravenous patient-controlled analgesia: how to give and what to mix? Yonsei Med J 2014;55:800-6. https://doi.org/10.3349/ymj.2014.55.3.800
  7. Izquierdo R, Voloshin I, Edwards S, Freehill MQ, Stanwood W, Wiater JM, et al. Treatment of glenohumeral osteoarthritis. J Am Acad Orthop Surg 2010;18:375-82. https://doi.org/10.5435/00124635-201006000-00010
  8. Rathmell JP, Wu CL, Sinatra RS, Ballantyne JC, Ginsberg B, Gordon DB, et al. Acute post-surgical pain management: a critical appraisal of current practice, December 2-4, 2005. Reg Anesth Pain Med 2006;31(4 Suppl 1):1-42. https://doi.org/10.1016/j.rapm.2006.05.002
  9. Hansen CA, Inacio MC, Pratt NL, Roughead EE, Graves SE. Chronic use of opioids before and after total knee arthroplasty: a retrospective cohort study. J Arthroplasty 2017;32:811-7. https://doi.org/10.1016/j.arth.2016.09.040
  10. Ilfeld BM, Wright TW, Enneking FK, Morey TE. Joint range of motion after total shoulder arthroplasty with and without a continuous interscalene nerve block: a retrospective, case-control study. Reg Anesth Pain Med 2005;30:429-33.
  11. Antognini JF, Wang XW, Piercy M, Carstens E. Propofol directly depresses lumbar dorsal horn neuronal responses to noxious stimulation in goats. Can J Anaesth 2000;47:273-9. https://doi.org/10.1007/BF03018926
  12. Jewett BA, Gibbs LM, Tarasiuk A, Kendig JJ. Propofol and barbiturate depression of spinal nociceptive neurotransmission. Anesthesiology 1992;77:1148-54. https://doi.org/10.1097/00000542-199212000-00016
  13. Goldstein FJ. Adjuncts to opioid therapy. J Am Osteopath Assoc 2002;102(9 Suppl 3):S15-21.
  14. Holtman JR Jr, Sloan JW, Jing X, Wala EP. Modification of morphine analgesia and tolerance by flumazenil in male and female rats. Eur J Pharmacol 2003;470:149-56. https://doi.org/10.1016/S0014-2999(03)01782-5
  15. Ogurlu M, Sari S, Kucuk M, Bakis M, Ugur B, Eshraghi YE, et al. Comparison of the effect of propofol and sevoflurane anaesthesia on acute and chronic postoperative pain after hysterectomy. Anaesth Intensive Care 2014;42:365-70. https://doi.org/10.1177/0310057X1404200314
  16. Freye E, Bruckner J, Latasch L. No difference in electroencephalographic power spectra or sensory-evoked potentials in patients anaesthetized with desflurane or sevoflurane. Eur J Anaesthesiol 2004;21:373-8. https://doi.org/10.1097/00003643-200405000-00004
  17. Yeo ST, Holdcroft A, Yentis SM, Stewart A. Analgesia with sevoflurane during labour: I. Determination of the optimum concentration. Br J Anaesth 2007;98:105-9. https://doi.org/10.1093/bja/ael326
  18. Hao S, Takahata O, Mamiya K, Iwasaki H. Sevoflurane suppresses noxious stimulus-evoked expression of Fos-like immunoreactivity in the rat spinal cord via activation of endogenous opioid systems. Life Sci 2002;71:571-80. https://doi.org/10.1016/S0024-3205(02)01704-6
  19. Rowley TJ, Daniel D, Flood P. The role of adrenergic and cholinergic transmission in volatile anesthetic-induced pain enhancement. Anesth Analg 2005;100:991-5. https://doi.org/10.1213/01.ANE.0000147708.73945.B3
  20. Mollhoff T, Herregods L, Moerman A, Blake D, MacAdams C, Demeyere R, et al. Comparative efficacy and safety of remifentanil and fentanyl in 'fast track' coronary artery bypass graft surgery: a randomized, double-blind study. Br J Anaesth 2001;87:718-26. https://doi.org/10.1093/bja/87.5.718
  21. Johansen JW, Sebel PS, Sigl JC. Clinical impact of hypnotic-titration guidelines based on EEG bispectral index (BIS) monitoring during routine anesthetic care. J Clin Anesth 2000;12:433-43. https://doi.org/10.1016/S0952-8180(00)00187-2
  22. Angst MS, Koppert W, Pahl I, Clark DJ, Schmelz M. Short-term infusion of the mu-opioid agonist remifentanil in humans causes hyperalgesia during withdrawal. Pain 2003;106:49-57. https://doi.org/10.1016/S0304-3959(03)00276-8
  23. Guignard B, Bossard AE, Coste C, Sessler DI, Lebrault C, Alfonsi P, et al. Acute opioid tolerance: intraoperative remifentanil increases postoperative pain and morphine requirement. Anesthesiology 2000;93:409-17. https://doi.org/10.1097/00000542-200008000-00019
  24. Orser BA, Bertlik M, Wang LY, MacDonald JF. Inhibition by propofol (2,6 di-isopropylphenol) of the N-methyl-D-aspartate subtype of glutamate receptor in cultured hippocampal neurones. Br J Pharmacol 1995;116:1761-8. https://doi.org/10.1111/j.1476-5381.1995.tb16660.x
  25. Criswell HE, Ming Z, Pleasant N, Griffith BL, Mueller RA, Breese GR. Macrokinetic analysis of blockade of NMDA-gated currents by substituted alcohols, alkanes and ethers. Brain Res 2004;1015:107-13. https://doi.org/10.1016/j.brainres.2004.04.050
  26. Hollmann MW, Liu HT, Hoenemann CW, Liu WH, Durieux ME. Modulation of NMDA receptor function by ketamine and magnesium. Part II: interactions with volatile anesthetics. Anesth Analg 2001;92:1182-91. https://doi.org/10.1097/00000539-200105000-00020
  27. Shin SW, Cho AR, Lee HJ, Kim HJ, Byeon GJ, Yoon JW, et al. Maintenance anaesthetics during remifentanil-based anaesthesia might affect postoperative pain control after breast cancer surgery. Br J Anaesth 2010;105:661-7. https://doi.org/10.1093/bja/aeq257
  28. Kotani Y, Shimazawa M, Yoshimura S, Iwama T, Hara H. The experimental and clinical pharmacology of propofol, an anesthetic agent with neuroprotective properties. CNS Neurosci Ther 2008;14:95-106. https://doi.org/10.1111/j.1527-3458.2008.00043.x
  29. Franck M, Radtke FM, Apfel CC, Kuhly R, Baumeyer A, Brandt C, et al. Documentation of post-operative nausea and vomiting in routine clinical practice. J Int Med Res 2010;38:1034-41. https://doi.org/10.1177/147323001003800330