title: Propofol reduces early post-operative pain after gynecological laparoscopy.
abstract: BACKGROUND
  There is some evidence that propofol may reduce post-operative pain. However, the results on the analgesic effects of propofol are inconsistent. Thus, we hypothesized that propofol reduces acute pain if confounding factors like opioids are avoided.
  
  
  METHODS
  In this prospective, randomized, subject- and assessor-blind, parallel-group, head-to-head comparative study, 90 American Society of Anesthesiologists I or II females underwent elective laparoscopies were randomized to receive either propofol-based (PR), or sevoflurane-based (SR), or sevoflurane-propofol-based anesthesia (SPR). Pain score at rest assessed by a numerical rating scale at 0.5 h after surgery was the primary outcome. The secondary outcomes included pain score at 1 and 24 h post-operatively, duration of post-anesthesia care units stay (PACU), incidence of post-operative nausea and vomiting, incidence of shivering, and post-operative quality of recovery score (QoR-40) within the first 24 h post-operatively.
  
  
  RESULTS
  No patients received rescue analgesia. The pain score at 0.5 h post-operatively was less in group PR when compared with group SR (0.7 ± 1.4 vs. 2.1 ± 1.8; P = 0.010) or group SPR (0.7 ± 1.4 vs. 2.1 ± 2.2; P = 0.008). Group PR was also associated with shorter PACU stay than group SR (21.8 ± 5.7 vs. 26.2 ± 6.9; P = 0.050) or group SPR (21.8 ± 5.7 vs. 27.8 ± 8.9; P = 0.005). Intraoperative bispectral index values, hemodynamic values and post-operative QoR-40 scores did not differ among the three groups.
  
  
  CONCLUSIONS
  Propofol anesthesia was associated with significantly less pain at 0.5 and 1 h after surgery in patients undergoing gynecological laparoscopies with planned opioid-free post-operative analgesia.
authors.affiliation: Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.forename: W
authors.initials: W
authors.lastname: Mei
authors.forename: P
authors.initials: P
authors.lastname: Wang
authors.forename: Y
authors.initials: Y
authors.lastname: Yu
authors.forename: W
authors.initials: W
authors.lastname: Qian
authors.forename: Z G
authors.initials: ZG
authors.lastname: Zhang
authors.forename: Y K
authors.initials: YK
authors.lastname: Tian
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007247:Infertility, Female / Q000601:surgery; D010535:Laparoscopy; D008738:Methyl Ethers; D016343:Monitoring, Intraoperative; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D010880:Piperidines / Q000627:therapeutic use; D015742:Propofol / Q000627:therapeutic use*; D011446:Prospective Studies; D000077208:Remifentanil; D018401:Sample Size; D000077149:Sevoflurane; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D015742:Propofol