title: Randomized, controlled trial comparing the effects of anesthesia with propofol, isoflurane, desflurane and sevoflurane on pain after laparoscopic cholecystectomy.
abstract: BACKGROUND
  Pain is the primary complaint and the main reason for prolonged recovery after laparoscopic cholecystectomy. The authors hypothesized that patients undergoing laparoscopic cholecystectomy will have less pain four hours after surgery when receiving maintenance of anesthesia with propofol when compared to isoflurane, desflurane, or sevoflurane.
  
  
  METHODS
  In this prospective, randomized trial, 80 patients scheduled for laparoscopic cholecystectomy were assigned to propofol, isoflurane, desflurane, or sevoflurane for the maintenance of anesthesia. Our primary outcome was pain measured on the numeric analog scale four hours after surgery. We also recorded intraoperative use of opioids as well as analgesic consumption during the first 24h after surgery.
  
  
  RESULTS
  There was no statistically significant difference in pain scores four hours after surgery (p=0.72). There were also no statistically significant differences in pain scores between treatment groups during the 24h after surgery (p=0.45). Intraoperative use of fentanyl and morphine did not vary significantly among the groups (p=0.21 and 0.24, respectively). There were no differences in total morphine and hydrocodone/APAP use during the first 24h (p=0.61 and 0.53, respectively).
  
  
  CONCLUSIONS
  Patients receiving maintenance of general anesthesia with propofol do not have less pain after laparoscopic cholecystectomy when compared to isoflurane, desflurane, or sevoflurane.
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, TX, United States. Electronic address: jaimeo@bcm.edu.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ortiz
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Lee C
authors.initials: LC
authors.lastname: Chang
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Tolpin
authors.affiliation: Dan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Charles G
authors.initials: CG
authors.lastname: Minard
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Bradford G
authors.initials: BG
authors.lastname: Scott
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Rivers
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D000077335:Desflurane; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D000077149:Sevoflurane; D016037:Single-Blind Method; D013997:Time Factors; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D009020:Morphine; D000077335:Desflurane; D007530:Isoflurane; D005283:Fentanyl; D015742:Propofol
keywords: Inhalational anesthetics; Laparoscopic cholecystectomy; Pain; Propofol