title: The influence of propofol and sevoflurane on intestinal motility during laparoscopic surgery.
abstract: BACKGROUND
  Volatile anaesthetics have an influence on small bowel peristalsis during laparoscopic surgery. A recent study concluded that desflurane increased intestinal motility compared to sevoflurane. Hence, a desflurane-based anaesthesia protocol may reduce surgical exposure during intestinal suturing or stapling due to small bowel hyperperistalsis. The effect of propofol on intestinal motility is not well studied. We tested the hypothesis that a propofol-remifentanil anaesthesia increases intestinal contractions in comparison with a sevoflurane-remifentanil anaesthesia.
  
  
  METHODS
  Patients scheduled for laparoscopic gastric bypass surgery were randomized in this single blind randomized controlled trial to receive remifentanil combined with sevoflurane or propofol (ISRCTN 12921661). Bispectral index monitoring was used to guide depth of anaesthesia. Visual observation of peristaltic waves was performed during 1 min at the planned site of the jejunostomy. Statistical analysis was performed using Wilcoxon two-sample test.
  
  
  RESULTS
  After obtaining written informed consent 50 patients were included. Groups were similar for demographic variables, and depth of anaesthesia during the observations. The median number of peristaltic waves was lower in the sevoflurane-remifentanil group compared to the propofol-remifentanil group (0 vs. 6, P < 0.001).
  
  
  CONCLUSIONS
  Propofol-remifentanil increases intestinal motility compared with sevoflurane-remifentanil during laparoscopic gastric bypass surgery. A sevoflurane-based protocol can help to avoid disturbing peristalsis.
authors.affiliation: Department of Anaesthesiology, AZ Groeninge Hospital, Kortrijk, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Desmet
authors.affiliation: Department Cardiovascular Sciences, KU Leuven, Leuven, Belgium.|Department of Anaesthesiology, UZ Leuven, Leuven, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Vander Cruyssen
authors.affiliation: Department of Public Health and Primary Care, KU Leuven Campus Kulak, Kortrijk, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Pottel
authors.affiliation: Department of Anaesthesiology, AZ Groeninge Hospital, Kortrijk, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Carlier
authors.affiliation: Department of Abdominal Surgery, AZ Groeninge Hospital, Kortrijk, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Devriendt
authors.affiliation: Department of Abdominal Surgery, AZ Groeninge Hospital, Kortrijk, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Van Rooy
authors.affiliation: Department of Anaesthesiology, AZ Groeninge Hospital, Kortrijk, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: De Corte
mesh_terms: D000328:Adult; D000777:Anesthetics / Q000494:pharmacology*; D015220:Calcium Channels / Q000502:physiology; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000502:physiology; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D000077149:Sevoflurane; D016037:Single-Blind Method; D000074025:TRPA1 Cation Channel; D050916:TRPV Cation Channels / Q000502:physiology; D050051:Transient Receptor Potential Channels / Q000502:physiology
chemical_list: D000777:Anesthetics; D015220:Calcium Channels; D008738:Methyl Ethers; D009419:Nerve Tissue Proteins; D000074025:TRPA1 Cation Channel; C473350:TRPA1 protein, human; D050916:TRPV Cation Channels; C494482:TRPV1 protein, human; D050051:Transient Receptor Potential Channels; D000077149:Sevoflurane; D015742:Propofol