The Effect of Propofol Versus Volatile Anesthetics on Persistent Pain After Cardiac Surgery: A Randomized Controlled Trial
| Autor: | Hai Yu, Zhao Xu, Jian-Qiao Zheng, Shun-Hui Dai, Jia-Li Jiang, Lei-Lei He, Hong Yu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Quality of life Randomized controlled trial 030202 anesthesiology law medicine Humans Cardiac Surgical Procedures Propofol Pain Postoperative business.industry Incidence (epidemiology) Volatile anesthetic Chronic pain medicine.disease Acute Pain Confidence interval Cardiac surgery Anesthesiology and Pain Medicine Anesthesia Anesthetics Inhalation Quality of Life Cardiology and Cardiovascular Medicine business Anesthetics Intravenous medicine.drug |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 35:2438-2446 |
| ISSN: | 1053-0770 |
| DOI: | 10.1053/j.jvca.2020.10.025 |
| Popis: | Objectives Sternal incisions can generate persistent and intense post-sternotomy pain. Propofol has been shown to improve postoperative analgesia, but the preventive effect on persistent pain after cardiac surgery is unknown. The hypothesis of the present study was that intraoperative propofol-based anesthesia compared with volatile anesthesia could reduce the risk of chronic pain after cardiac surgery. Design A single-center, two-arm, patient-and-evaluator-blinded, randomized controlled trial. Setting A single major urban teaching and university hospital. Patients Five-hundred adult patients undergoing cardiac surgery via sternotomy randomly were assigned. With six withdrawals from the study and five from surgery, 244 in the total intravenous anesthesia group and 245 in the volatile group were included in the modified intention-to-treat analysis. Interventions Patients randomly were assigned to receive either propofol-based total intravenous anesthesia or volatile anesthesia during surgery. Measurements and Main Results The primary outcomes were the incidence of pain at three, six, and 12 months after surgery defined as pain score >0 on the numeric rating scale. The secondary outcomes included acute pain, opioid use during the first 72 hours after surgery, and quality of life. The use of propofol did not significantly affect chronic pain at three months (55.4% v 52.9%, difference 2.5%, 95% confidence interval [CI] –6.6 to 11.6; p = 0.656), six months (35.5% v 37.5%, difference –2.0%, 95% CI –10.9 to 6.9; p = 0.657), or 12 months (18.2% v 20.7%, difference –2.5%, 95% CI –9.8 to 4.8; p = 0.495) compared with volatile anesthetics. Furthermore, there were no differences in acute pain score; morphine-equivalent consumption during the first 72 hours; and quality of life at three, six, and 12 months after surgery. Conclusions Intraoperative administration of propofol did not reduce persistent pain after cardiac surgery compared with volatile anesthetics. |
| Databáze: | OpenAIRE |
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