Postoperative pain assessment after anesthesia with sevoflurane,isoflurane or propofol

Objective To compare pain intensities during the first 24 h postoperatively in patients undergoing abdominal hysterectomy or myomectomy with sevoflurane,isoflurane or propofol anesthesia.Methods Ninety patients undergoing elective abdominal hysterectomy or myomectomy were randomly assigned to 3 groups;there were 30 patients in each group.General anesthesia in group sevoflurane(Sevo),group isoflurane(Iso) and group propofol(Prop) was maintained with sevoflurane,isoflurane inhalation or propofol intravenous target controlled infusion(TCI) after intravenous induction and tracheal intubation.Numerical rating scale at rest(NRSrest),numerical rating scale cough(NRScough) and cumulative fentanyl consumption were recorded at 1,2,4,8 and 24 h after surgeries.Results Cumulative fentanyl consumption was not markedly different between the 3 groups at 1,2,4,8 or 24 h postoperatively(P0.05).NRSrest and NRScough in group Prop were significantly lower than those in groups Sevo and Iso 1 h postoperatively(P0.05);NRSrest and NRScough in group Prop were significantly lower than that in group Iso 2 h postoperatively(P0.05),but did not differ from that in group Sevo.NRS values at other time points were similar among the 3 groups.Conclusion General anesthesia maintained with sevoflurane,isoflurane inhalation or propofol intravenous perfusion have different effects on postoperative pain.Postoperative pain is much severe in general anesthesia with isoflurane and sevoflurane inhalation compared with propofol intravenous infusion.Moreover,postoperative pain is much severer and lasted longer with isoflurane anesthesia.(Shanghai Med J,2011,34: 735-738)