Effects of propofol anesthesia versus sevoflurane anesthesia on postoperative pain after radical gastrectomy: a randomized controlled trial.

purposeAfter a radical gastrectomy, patients may experience severe pain. Some studies have reported that the use of propofol significantly reduced postoperative pain, while others have argued that this effect was not significant. Thus, we aimed to assess whether anesthesia with propofol could help to reduce pain after an open radical gastrectomy procedure. PATIENTS AND

methodsSixty patients who were scheduled to undergo a laparotomy for radical gastrectomy were randomly assigned to either the propofol or sevoflurane group (n=30 each). A target-controlled infusion of propofol or inhalation of sevoflurane, titrated to bispectral index of 40-60, was maintained. All patients were administered a standardized multimodal analgesic plan, including intraoperative dexmedetomidine, dexamethasone, and postoperative flurbiprofen axetil, as well as patient-controlled fentanyl. Hemodynamics, pain scores, fentanyl consumption, adverse events, and the incidence of chronic pain 1 month and 3 months following hospital discharge were recorded.

resultsThe intensity of postoperative pain was relatively low to moderate in all the patients. The propofol group showed lower pain scores, at rest and while coughing, up to 48 h postoperatively compared to the sevoflurane group (

conclusionsOverall, the multimodal analgesic approach reduced postoperative pain after an open radical gastrectomy procedure in all patients anesthetized with either propofol or sevoflurane. Furthermore, our results indicated better analgesic outcome for the propofol group, especially in the early postoperative period.