title: [Comparison of requirement for postoperative analgesics after inhalation and total intravenous anesthesia].
abstract: BACKGROUND
  We evaluated the requirement for postoperative analgesics in 88 patients undergoing abdominal total hysterectomy with inhalation anesthesia or with total intravenous anesthesia.
  
  
  METHODS
  Anesthesia was induced in the inhalation anesthesia (GOS, n = 52) group with propofol and fentanyl, and maintained with sevoflurane, nitrous oxide balanced with oxygen, and additional administrations of fentanyl up to 0.2 mg in total. The patients in the total intravenous anesthesia (TIVA, n = 36) group were managed with target controlled infusion for propofol and intermittent administration of fentanyl. Effect site concentrations of fentanyl at the end of surgery were calculated using a pharmacokinetic-pharmacodynamic model. We divided the postoperative time course and evaluated the types, dosages, and prescription times of postoperative analgesics in each.
  
  
  RESULTS
  Both total dosage and effect-site concentration of fentanyl were higher in the TIVA group than in the GOS group, and total prescription time in the TIVA group was significantly less during the 24 hrs after the operation. Supplemental prescription intervals of buprenorphine were significantly less in the TIVA group. Since administration of fentanyl during operation was adequate, patients in the TIVA group were considered to be in a sufficient analgesic state at the end of operation.
  
  
  CONCLUSIONS
  The postoperative pain can be reduced with TIVA.
authors.affiliation: Department of Anesthesiology, Tokyo Women's Medical University, Tokyo 162-8666.
authors.forename: Kotoe
authors.initials: K
authors.lastname: Kamata
authors.forename: Osamu
authors.initials: O
authors.lastname: Nagata
authors.forename: Hiroko
authors.initials: H
authors.lastname: Iwakiri
authors.forename: Makoto
authors.initials: M
authors.lastname: Ozaki
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D002047:Buprenorphine / Q000008:administration & dosage; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000493:pharmacokinetics; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D005283:Fentanyl