title: Effects of Intra-Operative Total Intravenous Anaesthesia with Propofol versus Inhalational Anaesthesia with Sevoflurane on Post-Operative Pain in Liver Surgery: A Retrospective Case-Control Study.
abstract: BACKGROUND
  Patients receiving total intravenous anesthesia (TIVA) with propofol have been shown to experience less postoperative pain. We evaluated the post-operative analgesic effects of propofol compared with sevoflurane maintenance of anesthesia in liver surgery. This study was registered at ClinicalTrials.gov (NCT02179437).
  
  
  METHODS
  In this retrospective study, records of patients who underwent liver surgery between 2010 and 2013 were reviewed. Ninety-five patients anesthetized with propofol TIVA were matched with 95 patients anesthetized with sevoflurane. Numeric pain rating scale (NRS) pain scores, postoperative morphine consumption, side effects and patients' satisfaction with pain relief were evaluated.
  
  
  RESULTS
  The TIVA group reported lower NRS pain scores during coughing on postoperative days 1 and 2 but not 3 (p = 0.0127, p = 0.0472, p = 0.4556 respectively). They also consumed significantly less daily (p = 0.001 on day 1, p = 0.0231 on day 2, p = 0.0004 on day 3), accumulative (p = 0.001 on day 1, p<0.0001 on day 2 and p = 0.0064 on day 3) and total morphine (p = 0.03) when compared with the sevoflurane group. There were no differences in total duration of intravenous patient controlled analgesia (PCA) morphine use and patient satisfaction. No difference was found in reported side effects.
  
  
  CONCLUSIONS
  Patients anesthetized with propofol TIVA reported less pain during coughing and consumed less daily, accumulative and total morphine after liver surgery.
authors.affiliation: Department of Anaesthesiology, Queen Mary Hospital, Hong Kong, China.
authors.forename: Alfred Chor San
authors.initials: AC
authors.lastname: Chan
authors.affiliation: Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, Hong Kong, China.
authors.forename: Qiu
authors.initials: Q
authors.lastname: Qiu
authors.affiliation: Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, Hong Kong, China.
authors.forename: Siu Wai
authors.initials: SW
authors.lastname: Choi
authors.affiliation: Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, Hong Kong, China.
authors.forename: Stanley Sau Ching
authors.initials: SS
authors.lastname: Wong
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China.
authors.forename: Albert Chi Yan
authors.initials: AC
authors.lastname: Chan
authors.affiliation: Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, Hong Kong, China.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Irwin
authors.affiliation: Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, Hong Kong, China.
authors.forename: Chi Wai
authors.initials: CW
authors.lastname: Cheung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000771:Anesthesia, Intravenous / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000601:surgery*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage*; D012189:Retrospective Studies; D000077149:Sevoflurane
chemical_list: D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol